Pericardial Constriction: A Retrospective Study

Abstract

INTRODUCTION: Pericardial constriction is a disabling condition but having good prognosis if surgery is undertaken in time. Predominant lesion in developing count ries is thought to be tuberc!ulous but dhis concept needs change as tuberculosis is getting controlled. Diagnosis of Pericardial constriction can be made with fair certainty in most of cases. However, at times even invasive investigation like cardiac catheterization may fail to distinguish it from cardiomyopathy and operation may be the only way to ascertain the diagnosis. MATERiAL AND METHODS: About 2/3 of the cases were referred from Cardiology Unit and the rest from various medical units. Diagnosis was based on history, physical findings, E.C.G. Radiological investigations and Echocardiography, Cardiac catheterization was not done as a routine but only in doubtful cases. As it was our impression that tuberculosis is the dominant cause, cases had antituberculous treatrflent preoperatively varying from few weeks to few months. Length of anti-tuberculous treatment did not affect the postoperative morb idity or mortality. DISCUSSION: Pericardial constriction is not uncommon and currently we are operating an average of one case/month. It affects young and middle aged alike. Males are more frequently affected. In this series the age ranged from 2 1/2 years to 65 years, mean age 25 years.In order to do extensive pericardectomy some surgeons are doing pericardectomy under bypass or with pump ready. We on the other hand haie found that satisfactory decortication can be done using Lt. anterolateral approach(3).