Outcomes and Risk Factors Associated with Pericardiectomy in Patients with Constrictive Pericarditis: A Retrospective Study from China.

Bin Li, Chao Dong, Guangyu Pan, Ruofan Liu, Minghui Tong, Jianping Xu, Shen Liu
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Abstract

Purpose: Pericardiectomy is the definitive treatment option for constrictive pericarditis and is associated with a high prevalence of morbidity and mortality. However, information on the associated outcomes and risk factors is limited. We aimed to report the mid-term outcomes of pericardiectomy from a single center in China.

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.

Conclusion: Pericardiectomy remains a safe operation for constrictive pericarditis with optimal mid-term outcomes.

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与缩窄性心包炎患者心包切除术相关的疗效和风险因素:中国的一项回顾性研究
目的:心包切除术是治疗缩窄性心包炎的最终方法,其发病率和死亡率都很高。然而,有关相关结果和风险因素的信息却很有限。我们旨在报告中国单个中心的心包切除术中期疗效:我们回顾性回顾了2018年4月至2023年1月期间在我院接受心包切除术的患者数据:连续86例患者(平均年龄(46.1±14.7)岁;68.6例男性)通过胸骨中线切开术接受了心包切除术。最常见的病因是特发性(n = 60,69.8%),82 名患者(95.3%)属于纽约心脏协会功能 III/IV 级。共有32名患者(37.2%)接受了重新胸骨切开术,36名患者(41.9%)接受了并发症治疗,39名患者(45.3%)需要心肺旁路治疗。30天死亡率为5.8%,1年和5年存活率分别为88.3%和83.5%。多变量分析显示,术前二尖瓣关闭不全(MI)≥中度(危险比[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年死亡率增加有关:结论:心包切除术仍是治疗缩窄性心包炎的安全手术,且中期疗效最佳。
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