Pericardiectomy for chronic constrictive tuberculous pericarditis: risks and predictors of survival.

Abstract

We performed this study to determine the predictors of early and long-term survival in the surgical treatment of tuberculous pericarditis and to examine the risks of pericardiectomy and the functional outcome in patients after surgery. A retrospective analysis was undertaken in 36 consecutive patients, 26 female and 10 male, with a mean age 32.2 +/- 16.3, who underwent pericardiectomy for chronic constrictive pericarditis from February 1985 to February 2002. All patients received antitubercular therapy in the postoperative period. The operative mortality rate was 6% (2 patients); the cause of death in both cases was severe low-cardiac-output syndrome. Nonfatal intraoperative complications affected 3 patients (8%). The median stay in the intensive care unit was 3.7 +/- 3.1 days. The median hospital stay was 14 +/- 2.6 days. The median ventilation time was 11.9 +/- 1.8 hours. The median volume of blood transfused was 2.1 +/- 1.6 units. Advanced age, atrial fibrillation, concomitant tricuspid insufficiency, inotropic support and low cardiac output were significant negative predictors of survival, according to univariate analysis. There were 4 late deaths. Actuarial survival at 5 years was 75.9% +/- 9.14%. At the 1-year follow-up examination, improved functional status was noted in 88% of patients. We suggest that pericardiectomy be performed early and as radically as possible, in an effort to prevent chronic illness. A combination of chemotherapy and surgery yields gratifying results in the treatment of tuberculous pericarditis.

• Authors: Nilgun Bozbuga, Vedat Erentug, Ercan Eren, Hasan Basri Erdogan, Kaan Kirali, Arzu Antal, Esat Akinci, Cavat Yakut
• Journal: Texas Heart Institute journal (Tex Heart Inst J) Vol. 30 Issue 3 Pg. 180-5 ( 2003) ISSN: 0730-2347 [Print] United States
• PMID: 12959199 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Chronic Disease
• Female
• Humans
• Male
• Middle Aged
• Pericardiectomy (adverse effects)
• Pericarditis, Constrictive (mortality, physiopathology, surgery)
• Pericarditis, Tuberculous (mortality, physiopathology, surgery)
• Predictive Value of Tests
• Recovery of Function (physiology)
• Retrospective Studies
• Risk Factors
• Survival Rate
• Time Factors