Skip to main content

Surgical Treatment of Pericardial Disease in the Elderly

  • Chapter
  • First Online:
  • 1144 Accesses

Abstract

Published data on pericardial disease in the elderly population are scarce. There are microanatomic changes that occur with aging that reduce the elasticity of the pericardial sac, which are presumed to make the elderly more hemodynamically sensitive to the ill effects of pericardial effusion. Certain diseases, such as postpericardiotomy syndrome, Dressler’s syndrome, and neoplasms, are more frequently seen in the elderly patients. Although not historically a disease of the elderly, constrictive pericarditis is becoming just that due to a shift in etiology away from tuberculosis in much of the industrialized world. Optimal management of any pericardial disease in the elderly must take into account frequent and occasionally severe comorbidities, as well as occasionally complex social situations requiring careful hospital discharge planning.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Holt JP. The normal pericardium. Am J Cardiol. 1970;26(5):455–65.

    Article  PubMed  CAS  Google Scholar 

  2. Spodick DH. Macrophysiology, microphysiology, and anatomy of the pericardium: a synopsis. Am Heart J. 1992;124(4):1046–51.

    Article  PubMed  CAS  Google Scholar 

  3. Goldstein JA. Cardiac tamponade, constrictive pericarditis, and restrictive cardiomyopathy. Curr Probl Cardiol. 2004;29(9):503–67.

    Article  PubMed  Google Scholar 

  4. Spodick DH. Pericardial diseases. In: Braunwald E, Zipes DP, Lippy P, editors. Heart disease: a textbook of cardiovascular medicine. 6th ed. Philadelphia: WB Saunders; 2001. p. 1823–76.

    Google Scholar 

  5. Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684–90.

    Article  PubMed  Google Scholar 

  6. Glantz SA, Misbach GA, Moores WY, Mathey DG, Lekven J, Stowe DF, et al. The pericardium substantially affects the left ventricular diastolic pressure-volume relationship in the dog. Circ Res. 1978;42(3):433–41.

    Article  PubMed  CAS  Google Scholar 

  7. Maisch B, Ristić AD. The classification of pericardial disease in the age of modern medicine. Curr Cardiol Rep. 2002;4(1):13–21.

    Article  PubMed  Google Scholar 

  8. Spodick DH. Pericardial rub. Prospective, multiple observer investigation of pericardial friction in 100 patients. Am J Cardiol. 1975;35(3):357–62.

    Article  PubMed  CAS  Google Scholar 

  9. Spodick DH. Acute pericarditis: current concepts and practice. JAMA. 2003;289(9):1150–3.

    Article  PubMed  Google Scholar 

  10. Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet. 2004;363(9410):717–27.

    Article  PubMed  Google Scholar 

  11. Koh KK, Kim EJ, Cho CH, Choi MJ, Cho SK, Kim SS, et al. Adenosine deaminase and carcinoembryonic antigen in pericardial effusion diagnosis, especially in suspected tuberculous pericarditis. Circulation. 1994;89(6):2728–35.

    Article  PubMed  CAS  Google Scholar 

  12. Roumie CL, Choma NN, Kaltenbach L, Mitchel Jr EF, Arbogast PG, Griffin MR. Non-aspirin NSAIDs, cyclooxygenase-2 inhibitors and risk for cardiovascular events-stroke, acute myocardial infarction, and death from coronary heart disease. Pharmacoepidemiol Drug Saf. 2009;18(11):1053–63.

    Article  PubMed  CAS  Google Scholar 

  13. Dooley DP, Carpenter JL, Rademacher S. Adjunctive corticosteroid therapy for tuberculosis: a critical reappraisal of the literature. Clin Infect Dis. 1997;25(4):872–87.

    Article  PubMed  CAS  Google Scholar 

  14. Hoit BD. Management of effusive and constrictive pericardial heart disease. Circulation. 2002;105(25):2939–42.

    Article  PubMed  Google Scholar 

  15. Adler Y, Finkelstein Y, Guindo J, Rodriguez de la Serna A, Shoenfeld Y, Bayes-Genis A, et al. Colchicine treatment for ­recurrent ­pericarditis. A decade of experience. Circulation. 1998;97(21):2183–5.

    Article  PubMed  CAS  Google Scholar 

  16. Fowler NO. Constrictive pericarditis: new aspects. Am J Cardiol. 1982;50(5):1014–7.

    Article  PubMed  CAS  Google Scholar 

  17. Ling LH, Oh JK, Schaff HV, Danielson GK, Mahoney DW, Seward JB, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999;100(13):1380–6.

    Article  PubMed  CAS  Google Scholar 

  18. Rajagopalan N, Garcia MJ, Rodriguez L, Murray RD, Apperson-Hansen C, Stugaard M, et al. Comparison of new Doppler echocardiographic methods to differentiate constrictive pericardial heart disease and restrictive cardiomyopathy. Am J Cardiol. 2001;87(1):86–94.

    Article  PubMed  CAS  Google Scholar 

  19. Wang ZJ, Reddy GP, Gotway MB, Yeh BM, Hetts SW, Higgins CB. CT and MR imaging of pericardial disease. Radiographics. 2003;23 Spec No:S167–80.

    Google Scholar 

  20. Schoenfeld MH, Supple EW, Dec Jr GW, Fallon JT, Palacios IF. Restrictive cardiomyopathy versus constrictive pericarditis: role of endomyocardial biopsy in avoiding unnecessary thoracotomy. Circulation. 1987;75(5):1012–7.

    Article  PubMed  CAS  Google Scholar 

  21. Oh JK, Hatle LK, Mulvagh SL, Tajik AJ. Transient constrictive pericarditis: diagnosis by two-dimensional Doppler echocardiography. Mayo Clin Proc. 1993;68(12):1158–64.

    Article  PubMed  CAS  Google Scholar 

  22. McCaughan BC, Schaff HV, Piehler JM, Danielson GK, Orszulak TA, Puga FJ, et al. Early and late results of pericardiectomy for constrictive pericarditis. J Thorac Cardiovasc Surg. 1985;89(3):340–50.

    PubMed  CAS  Google Scholar 

  23. Chowdhury UK, Subramaniam GK, Kumar AS, Airan B, Singh R, Talwar S, et al. Pericardiectomy for constrictive pericarditis: a clinical, echocardiographic, and hemodynamic evaluation of two ­surgical techniques. Ann Thorac Surg. 2006;81(2):522–9.

    Article  PubMed  Google Scholar 

  24. Villavicencio MA, Dearani JA, Sundt TM. Op Techs T CV Surg. 2008 Spring 13(1):2–13.

    Google Scholar 

  25. Spodick DH. Images in cardiology. Truly total electric alternation of the heart. Clin Cardiol. 1998;21(6):427–8.

    Article  PubMed  CAS  Google Scholar 

  26. Spodick DH. Electric alternation of the heart. Its relation to the kinetics and physiology of the heart during cardiac tamponade. Am J Cardiol. 1962;10:155–65.

    Article  PubMed  CAS  Google Scholar 

  27. Becit N, Unlü Y, Ceviz M, Koçogullari CU, Koçak H, Gürlertop Y. Subxiphoid pericardiostomy in the management of pericardial effusions: case series analysis of 368 patients. Heart. 2005;91(6):785–90.

    Article  PubMed  CAS  Google Scholar 

  28. Allen KB, Faber LP, Warren WH, Shaar CJ. Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg. 1999;67(2):437–40.

    Article  PubMed  CAS  Google Scholar 

  29. Georghiou GP, Stamler A, Sharoni E, Fichman-Horn S, Berman M, Vidne BA, et al. Video-assisted thoracoscopic pericardial window for diagnosis and management of pericardial effusions. Ann Thorac Surg. 2005;80(2):607–10.

    Article  PubMed  Google Scholar 

  30. O’Brien PK, Kucharczuk JC, Marshall MB, Friedberg JS, Chen Z, Kaiser LR, et al. Comparative study of subxiphoid versus video-thoracoscopic pericardial “window”. Ann Thorac Surg. 2005;80(6):2013–9.

    Article  PubMed  Google Scholar 

  31. Asensio JA, Berne JD, Demetriades D, Chan L, Murray J, Falabella A, et al. One hundred five penetrating cardiac injuries: a 2-year prospective evaluation. J Trauma. 1998;44(6):1073–82.

    Article  PubMed  CAS  Google Scholar 

  32. Warren WH. Malignancies involving the pericardium. Semin Thorac Cardiovasc Surg. 2000;12(2):119–29.

    PubMed  CAS  Google Scholar 

  33. Shepherd FA. Malignant pericardial effusion. Curr Opin Oncol. 1997;9(2):170–4.

    Article  PubMed  CAS  Google Scholar 

  34. Maruyama R, Yokoyama H, Seto T, Nagashima S, Kashiwabara K, Araki J, et al. Catheter drainage followed by the instillation of bleomycin to manage malignant pericardial effusion in non-small cell lung cancer: a multi-institutional phase II trial. J Thorac Oncol. 2007;2(1):65–8.

    Article  PubMed  Google Scholar 

  35. Prince SE, Cunha BA. Postpericardiotomy syndrome. Heart Lung. 1997;26(2):165–8.

    Article  PubMed  CAS  Google Scholar 

  36. Imazio M, Cecchi E, Trinchero R, COPPS Investigators. Colchicine for the prevention of the postpericardiotomy syndrome: the COPPS trial. Int J Cardiol. 2007;121(2):198–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joshua Kindelan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kindelan, J., de Hoyos, A. (2011). Surgical Treatment of Pericardial Disease in the Elderly. In: Katlic, M. (eds) Cardiothoracic Surgery in the Elderly. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0892-6_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-0892-6_34

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0891-9

  • Online ISBN: 978-1-4419-0892-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics