Tratamiento Quirúrgico De La Pericarditis Constrictiva; 15 Años De Experiencia

Introduction and objectives: Constrictive pericarditis is a rare disease with a high morbidity and mortality. His treatment is the surgical pericardiectomy. The aim of this study is to present our experience and analyze the short and long-term outcomes. Methods: All patients who were underwent to a subtotal pericardiectomy for constrictive pericarditis from january 2003 to february 2018 were included. A description of the serie was made, short and longterm outcomes and mortality risk factors were analyzed. Results: A total of 53 patients were underwent to a subtotal pericardiectomy. The mean age was 60.5 years (+/- 10.3). The 71.7% were males. The most frequent etiology was idiopathic (52.8%), followed by infectious/inflammatory (28.3%) and postcardiotomy (11.3%). A 62.3% of the patients had NYHA functional class III-IV preoperatively. In-hospital mortality rate was 11.3% (n 6). There were no recurrences in follow-up. Median postoperative follow-up was 64.9 months (IQR 3.1 - 131.2). One, 5 and 10 years survival rates were 86.4%, 81.6% and 75.1%, respectively. NHYA functional class IV was the only independent factor of risk of long-term mortality. Conclusions: Pericardiectomy is the surgical technique of choice for the treatment of constrictive pericarditis. Although it is a procedure with high morbidity and mortality, it can be significantly reduced if the indication for surgery is early, before the appearance of refractory symptoms. In addition, an aggressive surgical technique prevents recurrence in long-term follow-up. (C) 2019 Sociedad Espanola de Cirugla Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.