背景:由于对心包切除术中心包钙化的临床意义缺乏了解,在确定心包切除术的最佳时机时,是否应考虑心包钙化是有争议的.本研究旨在探讨心包钙化对缩窄性心包炎患者行心包切除术后早期预后的影响。
方法:总之,44例缩窄性心包炎患者接受心包切除术。在排除三名同时接受手术的患者后,根据术前计算机断层扫描和病理检查确定的心包钙化,将41例患者分为两组.术前临床及影像学特点,术中数据,比较两组患者术后早期结局。进行多变量分析以确定与术后并发症相关的因素。
结果:有和无PC组包括21和20名患者,分别。心包钙化组30天死亡率无显著差异(n=1[5%]),无心包钙化组30天死亡率无显著差异(p>0.999)。其他术后早期结果变量在两组之间没有显着差异。然而,体外循环的使用与术后并发症相关(p<0.009,比值比:63.5,95%置信区间:5.13-3400).
结论:心包钙化并未显著影响心包切除术后的预后。进一步的全面研究,包括具有较大样本量和纵向设计的样本,有必要确定心包钙化是否会显著影响手术干预的时机。
BACKGROUND: Owing to the lack of understanding of the clinical significance of pericardial calcification during pericardiectomy, whether pericardial calcification should be considered when determining the optimal timing for pericardiectomy is debatable. We aimed to investigate the effect of pericardial calcification on early postoperative outcomes in patients who underwent pericardiectomy for constrictive pericarditis.
METHODS: Altogether, 44 patients who underwent pericardiectomy for constrictive pericarditis were enrolled. After excluding three patients who underwent concurrent surgeries, a total of 41 patients were categorized into two groups based on the presence of pericardial calcification as determined by preoperative computed tomography and pathological examination. Preoperative clinical and imaging characteristics, intraoperative data, and early postoperative outcomes were compared between the two groups. A multivariable analysis was performed to identify the factors associated with postoperative complications.
RESULTS: The group with and without PC comprised 21 and 20 patients, respectively. No significant differences were observed in 30-day mortality (n = 1 [5%]) in the group with pericardial calcification and no mortality in the group without pericardial calcification (p > 0.999). Other early postoperative outcome variables did not demonstrate any significant differences between the two groups. However, the use of cardiopulmonary bypass was associated with postoperative complications (p < 0.009, odds ratio: 63.5, 95% confidence interval: 5.13-3400).
CONCLUSIONS: Pericardial calcification did not significantly affect the postoperative outcomes after pericardiectomy. Further comprehensive studies, including those with larger sample sizes and longitudinal designs, are necessary to determine whether pericardial calcification can significantly influence the timing of surgical intervention.