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.