Radical Pericardiectomy for Pericardial Diseases
Purpose of Review
The surgical management of constrictive pericarditis has evolved from a partial pericardiectomy via a thoracotomy approach to a more extensive removal of the pericardium. This review summarizes the published studies regarding surgical management of pericardial disease, focusing on the surgical technique of radical pericardiectomy for constrictive pericarditis.
Anterior phrenic to phrenic resection without the use of cardiopulmonary bypass has been performed in many centers. This approach achieves improvement in symptoms; however, there are patients who have progressive constriction of the remaining pericardium requiring a completion pericardiectomy. Recent studies show that the survival and functional outcome is superior after a complete pericardiectomy.
Our approach is to perform a complete pericardiectomy using cardiopulmonary bypass. In experienced centers, the outcomes have significantly improved with careful selection of patients, advances in pre- and postoperative care, and refinement in surgical techniques.
KeywordsPericardiectomy Constrictive pericarditis Recurrent pericarditis Cardiopulmonary bypass Cardiac surgery
Compliance with Ethical Standards
Conflict of Interest
Shinya Unai and Douglas R. Johnston declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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