Surgical treatment for chronic constrictive pericarditis.

ABSTRACT

One hundred and twelve patients were operated for constrictive pericarditis from December 1963 through May 1987 at J.J. Group of Hospitals, Bombay. All the patients had haemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. Preoperatively, the patients were either in NYHA class III (96 cases), or class IV (16 cases). All the patients had ascites and/or peripheral oedema with an enlarged liver. Pericardiectomy was performed through a left anterior thoracotomy (92 cases), or median sternotomy (20 cases). There was an early mortality (deaths occurring within 30 days of operation) in 21 cases (18.75%). Early mortality was related to preoperative disability of the patients. Post-operatively, NYHA classification of patients at six months after operation showed improvement in functional class with 80 patients in either class I or II and 6 patients in class III.