Abstract:
Remarkable advances have occurred in the understanding of the pathophysiology of pericardial diseases and the role of multimodality imaging in this field. Medical therapy and surgical options for pericardial diseases have also evolved substantially. Pericardiectomy is indicated for chronic or irreversible constrictive pericarditis, refractory recurrent pericarditis despite optimal medical therapy, or partial agenesis of the pericardium with a complication (eg, herniation). A multidisciplinary evaluation before pericardiectomy is essential for optimal patient outcomes. Overall, given the good outcomes reported, radical pericardiectomy on cardiopulmonary bypass, if feasible, is the preferred approach. Due to patient complexity, as well as the technical aspects of the surgery, pericardiectomy should be performed at high-volume centers that have the required expertise. The current review highlights the essential features of this multidisciplinary approach from diagnosis to recovery in patients undergoing pericardiectomy.
摘要:
在了解心包疾病的病理生理学以及多模态成像在该领域的作用方面已经取得了显着进展。心包疾病的药物治疗和手术选择也有了很大的发展。心包切除术适用于慢性或不可逆缩窄性心包炎。难治性复发性心包炎,尽管最佳药物治疗,或伴有并发症的心包部分发育不全(例如,疝)。心包切除术前的多学科评估对于最佳患者预后至关重要。总的来说,鉴于报告的良好结果,体外循环下的根治性心包切除术,如果可行,是首选方法。由于患者的复杂性,以及手术的技术方面,心包切除术应在具有所需专业知识的高容量中心进行.当前的评论强调了这种多学科方法从诊断到恢复的基本特征。