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.
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。