PDF(Pubmed)
Abstract：
OBJECTIVE: Pericardiectomy is the definitive treatment option for constrictive pericarditis and is associated with a high prevalence of morbidity and mortality. However, information on the associated outcomes and risk factors is limited. We aimed to report the mid-term outcomes of pericardiectomy from a single center in China.
METHODS: We retrospectively reviewed data collected from patients who underwent pericardiectomy at our institute from April 2018 to January 2023.
RESULTS: Eighty-six consecutive patients (average age, 46.1 ± 14.7 years; 68.6 men) underwent pericardiectomy through midline sternotomy. The most common etiology was idiopathic (n = 60, 69.8%), and 82 patients (95.3%) were in the New York Heart Association function class III/IV. In all, 32 (37.2%) patients underwent redo sternotomies, 36 (41.9%) underwent a concomitant procedure, and 39 (45.3%) required cardiopulmonary bypass. The 30-day mortality rate was 5.8%, and the 1-year and 5-year survival rates were 88.3% and 83.5%, respectively. Multivariable analysis revealed that preoperative mitral insufficiency (MI) ≥moderate (hazard ratio [HR], 6.435; 95% confidence interval [CI] [1.655-25.009]; p = 0.007) and partial pericardiectomy (HR, 11.410; 95% CI [3.052-42.663]; p = 0.000) were associated with increased 5-year mortality.
CONCLUSIONS: Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.
METHODS: We retrospectively reviewed data collected from patients who underwent pericardiectomy at our institute from April 2018 to January 2023.
RESULTS: Eighty-six consecutive patients (average age, 46.1 ± 14.7 years; 68.6 men) underwent pericardiectomy through midline sternotomy. The most common etiology was idiopathic (n = 60, 69.8%), and 82 patients (95.3%) were in the New York Heart Association function class III/IV. In all, 32 (37.2%) patients underwent redo sternotomies, 36 (41.9%) underwent a concomitant procedure, and 39 (45.3%) required cardiopulmonary bypass. The 30-day mortality rate was 5.8%, and the 1-year and 5-year survival rates were 88.3% and 83.5%, respectively. Multivariable analysis revealed that preoperative mitral insufficiency (MI) ≥moderate (hazard ratio [HR], 6.435; 95% confidence interval [CI] [1.655-25.009]; p = 0.007) and partial pericardiectomy (HR, 11.410; 95% CI [3.052-42.663]; p = 0.000) were associated with increased 5-year mortality.
CONCLUSIONS: Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.
摘要：
目的：心包切除术是缩窄性心包炎的明确治疗选择，其发病率和死亡率较高。然而,有关相关结果和风险因素的信息有限.我们旨在报告中国单个中心的心包切除术的中期结局。
方法：我们回顾性回顾了2018年4月至2023年1月在我们研究所接受心包切除术的患者的数据。
结果：86名连续患者（平均年龄，46.1±14.7岁；68.6名男性）通过中线胸骨切开术进行心包切除术。最常见的病因是特发性（n=60，69.8％），82例(95.3%)为纽约心脏协会功能III/IV级.总之,32例(37.2%)患者接受了重做胸膜切除术，36人(41.9%)接受了伴随手术，39（45.3％）需要体外循环。30天死亡率为5.8%,1年和5年生存率分别为88.3%和83.5%，分别。多变量分析显示术前二尖瓣关闭不全（MI）≥中度（风险比[HR]，6.435；95%置信区间[CI][1.655-25.009]；p=0.007）和部分心包切除术（HR，11.410；95%CI[3.052-42.663]；p=0.000）与5年死亡率增加相关。
结论：心包切除术仍是缩窄性心包炎的安全手术，中期预后最佳。
方法：我们回顾性回顾了2018年4月至2023年1月在我们研究所接受心包切除术的患者的数据。
结果：86名连续患者（平均年龄，46.1±14.7岁；68.6名男性）通过中线胸骨切开术进行心包切除术。最常见的病因是特发性（n=60，69.8％），82例(95.3%)为纽约心脏协会功能III/IV级.总之,32例(37.2%)患者接受了重做胸膜切除术，36人(41.9%)接受了伴随手术，39（45.3％）需要体外循环。30天死亡率为5.8%,1年和5年生存率分别为88.3%和83.5%，分别。多变量分析显示术前二尖瓣关闭不全（MI）≥中度（风险比[HR]，6.435；95%置信区间[CI][1.655-25.009]；p=0.007）和部分心包切除术（HR，11.410；95%CI[3.052-42.663]；p=0.000）与5年死亡率增加相关。
结论：心包切除术仍是缩窄性心包炎的安全手术，中期预后最佳。
