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心包钙化对心包切除术术后早期结局的影响:一项回顾性观察研究。

Impact of pericardial calcification on early postoperative outcomes after pericardiectomy: a retrospective observational study.

机构信息

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, Republic of Korea.

出版信息

J Cardiothorac Surg. 2024 Jul 15;19(1):449. doi: 10.1186/s13019-024-02842-4.

Abstract

BACKGROUND

Owing to the lack of understanding of the clinical significance of pericardial calcification during pericardiectomy, whether pericardial calcification should be considered when determining the optimal timing for pericardiectomy is debatable. We aimed to investigate the effect of pericardial calcification on early postoperative outcomes in patients who underwent pericardiectomy for constrictive pericarditis.

METHODS

Altogether, 44 patients who underwent pericardiectomy for constrictive pericarditis were enrolled. After excluding three patients who underwent concurrent surgeries, a total of 41 patients were categorized into two groups based on the presence of pericardial calcification as determined by preoperative computed tomography and pathological examination. Preoperative clinical and imaging characteristics, intraoperative data, and early postoperative outcomes were compared between the two groups. A multivariable analysis was performed to identify the factors associated with postoperative complications.

RESULTS

The group with and without PC comprised 21 and 20 patients, respectively. No significant differences were observed in 30-day mortality (n = 1 [5%]) in the group with pericardial calcification and no mortality in the group without pericardial calcification (p > 0.999). Other early postoperative outcome variables did not demonstrate any significant differences between the two groups. However, the use of cardiopulmonary bypass was associated with postoperative complications (p < 0.009, odds ratio: 63.5, 95% confidence interval: 5.13-3400).

CONCLUSIONS

Pericardial calcification did not significantly affect the postoperative outcomes after pericardiectomy. Further comprehensive studies, including those with larger sample sizes and longitudinal designs, are necessary to determine whether pericardial calcification can significantly influence the timing of surgical intervention.

摘要

背景

由于在施行心包切除术时对心包钙化的临床意义缺乏了解,因此心包切除术的最佳时机是否应考虑心包钙化仍存在争议。我们旨在研究心包钙化对缩窄性心包炎患者施行心包切除术的早期术后结果的影响。

方法

共纳入 44 例行心包切除术治疗缩窄性心包炎的患者。排除 3 例同时施行其它手术的患者后,根据术前 CT 和病理检查确定心包钙化情况,将总共 41 例患者分为心包钙化组和无心包钙化组。比较两组患者的术前临床和影像学特征、术中数据以及早期术后结果。采用多变量分析确定与术后并发症相关的因素。

结果

有心包钙化组和无心包钙化组分别包括 21 例和 20 例患者。有心包钙化组 30 天死亡率为 1 例(5%),无心包钙化组无死亡病例(p>0.999)。两组间其他早期术后结果变量无显著差异。然而,体外循环的使用与术后并发症相关(p<0.009,优势比:63.5,95%置信区间:5.13-3400)。

结论

心包钙化对心包切除术的术后结果无显著影响。需要进一步进行全面的研究,包括更大样本量和纵向设计的研究,以确定心包钙化是否能显著影响手术干预的时机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a09f/11247834/d005246100c2/13019_2024_2842_Fig1_HTML.jpg

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