A study sought to evaluate surgical outcomes among patients undergoing pericardiectomy for radiation-associated constrictive pericarditis. The results appeared in the Journal of Cardiac Surgery.
This retrospective analysis consisted of 100 patients (mean age, 57; 49% women) who underwent pericardiectomy for a diagnosis of constrictive pericarditis with a prior history of mediastinal irradiation from June 2002 to June 2019. Records were reviewed to look at the surgical approach, the extent of resection, early mortality, and late survival.
The results showed that the overall operative mortality was 10.1%, and the rate decreased over the study period; however, the researchers noted that the test of the trend was not statistically significant (P=0.062). Hodgkin’s disease was the most common malignancy (64%) for which mediastinal radiation had been received. Only 27% of patients had an isolated pericardiectomy, and concomitant pericardiectomy and valve surgery were performed in 46% of patients. Radical resection was performed in 50% of patients, whereas 47% of patients underwent subtotal resection.
Moreover, prolonged ventilation (26%), atrial fibrillation (21%), and pleural effusion (16%) were the most common postoperative complications. The overall one-, five-, and 10-year survival was 73.6%, 53.4%, and 32.1%, respectively. Increasing age (hazard ratio=1.044, 95% confidence interval 1.017-1.073) appeared to have a significant negative effect on overall survival in the univariate model, the researchers noted.
“Pericardiectomy performed for radiation-associated constrictive pericarditis has poor long-term outcomes. The early mortality, though high, has been showing a decreasing trend in the test of time,” the researchers concluded.
Keywords: mediastinal irradiation, operative mortality, pericardiectomy