Our Experience in the Surgical Treatment of Chronic Constrictive Pericarditis

Introduction: We reviewed the cases of 21 consecutive patients who underwent surgery for chronic constrictive pericarditis between January 2004 and January 2016, to determine causes, surgical techniques, mortality and morbidity rates, and improvement of functional capacity. Patients and Methods: Eleven of our patients were men (52.3%) and ten were women (47.7%); their average age was 48.71±15.6 years. The pericarditis was tuberculous in 13 patients (61.9%), idiopathic in 4 patients (19%), rheumatic in two patients (9.5%), post surgical in one patient (4.75%) and neoplastic in one patient (4.75%).  Results: In all the cases, our approach was median sternotomy. All anterior pericardium was resected from left phrenic nerve to right phrenic nerve. No patient required cardiopulmonary bypass. We had no early postoperative mortality. In the 1st postoperative month, functional capacity improved dramatically: the number of patients in New York Heart Association functional class IV moved from 13 (preoperatively) to 4; in class III, from 7 to 3; in class II, from 1 to 6; and in class I, from 0 to 10.  Conclusions: We recommend the median sternotomy approach for chronic constrictive pericarditis. Tuberculosis still remains the main cause at our country. It can be treated with excellent results nowadays. Keywords: surgical treatment, chronic constrictive pericarditis DOI: 10.7176/JMPB/68-03 Publication date: September 30 th 2020