surgical management of effusive constrictive

Background: The surgical approach for effusive constric-tive pericarditis (ECP) has not been extensively studied. We present our institution’s early and long-term results of peri-cardiectomy in our cohort of patients with ECP. Methods: Diagnosis was made primarily by echocardiog-raphy. Right heart catheterisation was performed in eight patients. Pre-operatively, 10 patients had undergone at least one previous attempt at therapeutic pericardiocentesis. Pericardiectomy was performed where appropriate (thick-ened or inflamed). Results: Of our 12 patients (50 % male, median age 48 years, range 17–72 years), the underlying aetiology included idiopathic in five (41.6%), tuberculosis in four (33%), and malignancy in three patients (25%). Elective surgery was performed in nine patients. Median values of both central venous pressure and pulmonary capillary wedge pressure decreased markedly postoperatively (from 16.5 to 11.0 mmHg, p = 0.02; 20.0–15.0 mmHg, p = 0.01, respec-tively). There was no in-hospital mortality. Follow up ranged from three months to nine years (median three years). Five (41.6%) patients died during the follow-up period, and cumulative two-year survival was 55.6 ± 1.5%. Conclusion: Pericardiectomy for ECP was effective, in terms of our early results, in patients unresponsive to medical ther-apy. Long-term survival depends on the underlying disease