Inamdar Kamran Y, Aikebaier Maimaiti, Mulati Abudureheman
Cardiovascular Surgery Department, The First Affiliated Hospital of Xinjiang Medical University, Urumchi, Xin Jiang, China.
Heart Surg Forum. 2014 Dec;17(6):E319-22. doi: 10.1532/HSF98.2013183.
Constrictive pericarditis is a slow progressive fibrosis of the pericardium leading to a variety of symptoms and signs over time. The disease poses a diagnostic challenge; restrictive cardiomyopathy and other syndromes associated with right-sided pressure abnormalities share similar symptoms and clinical findings. Pericardiectomy is considered the treatment of choice for constrictive pericarditis. Here we studied the effects of total radical pericardiectomy on hemodynamics in 37 patients diagnosed with constrictive pericarditis.
Between 2005 and 2012 thirty-seven patients, 31 males and 6 females, age range 15 to 69 years, underwent total pericardiectomy for constrictive pericarditis. Diagnosis was made on the basis of clinical, pathological and diagnostic modalities-ECG, x-rays, magnetic resonance imaging, computed tomography and echocardiogram. The surgical approach was median sternotomy and surgery was conducted without cardiopulmonary bypass.
Postoperative outcomes showed overall improvement in the majority of patients. Hemodynamics-stroke volume, cardiac output, ejection fraction, central venous pressure-were all measurably improved postoperatively. There was no postoperative mortality.
Radical pericardiectomy is a demonstrably useful procedure for correction of hemodynamic abnormalities and improvement of overall heart function in symptomatic patients with constrictive pericarditis.
缩窄性心包炎是一种心包的缓慢进行性纤维化，随着时间的推移会导致各种症状和体征。该疾病带来了诊断挑战；限制性心肌病和其他与右侧压力异常相关的综合征具有相似的症状和临床发现。心包切除术被认为是缩窄性心包炎的首选治疗方法。在此，我们研究了全根治性心包切除术对37例诊断为缩窄性心包炎患者血流动力学的影响。
2005年至2012年间，37例患者（31例男性，6例女性，年龄范围15至69岁）因缩窄性心包炎接受了全心包切除术。诊断基于临床、病理和诊断方法——心电图、X线、磁共振成像、计算机断层扫描和超声心动图。手术入路为正中胸骨切开术，手术在非体外循环下进行。
术后结果显示大多数患者总体情况有所改善。血流动力学指标——每搏量、心输出量、射血分数、中心静脉压——术后均有显著改善。无术后死亡病例。
对于有症状的缩窄性心包炎患者，根治性心包切除术对于纠正血流动力学异常和改善整体心脏功能显然是一种有用的手术。
