Surgery for Pericardial Syndromes in Adults and Children: Clarification of Questionable Aspects

• 作者: Ahmed Abdelrahman Elassal Ahmed Mohamed Dohain Gaser Abdelmohsen Abdelmohsen Husain Hamza Jabbad Khalid Ebrahim Al-Ebrahim Mohamed Hasan Abdelsalam Osman Osama Al-Radi Zaher Faisal Zaher
• 来源期刊: 心血管外科国际期刊(英文)
• 学科: 医学
• 关键词: SURGERY Pericardial Syndromes ADULTS CHILDREN
• 年，卷（期）: 2020,（11）
• 页码范围: 213-225
• 页数: 13页
• 分类号: R73

摘要

<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> The knowledge on pericardial disease has increased but the European Society of Cardiology in the last guidelines 2015 stated a section of perspective and unmet needs referring to the surgical management as one of these needs. Here, we present an institutional experience to contribute with </span><span style="font-family:Verdana;">other studies in explanation of questionable aspects about their surgical</span><span style="font-family:Verdana;"> management. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: Among 127 cases (93 adults and 34 children) that were diagnosed as pericardial syndrome, we retrospectively analyzed 45 cases (40 adults and 5 children) operated for pericardial syndrome from May 2012 to June 2019. Echocardiogram was the main preoperative diagnostic tool. Surgical approach was selected according to each diagnosis. Postoperative clinical assessment, recurrence and mortality rate were the main determinants of </span><span><span style="font-family:Verdana;">outcome. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: Regarding pericardial effusions, the mean preoperative</span></span><span style="font-family:Verdana;"> me</span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">dical treatment period was 17.7 ± 21.9 days and pericardial window through thoracotomy was the common approach (54.5%). In constrictive pericarditis, infection was the main etiology (40%), mean preoperative medical treatment period was 16 ± 8.8 days and complete pericardiectomy was the surgical procedure for most cases. Trans-sternal drainage was the standard approach for cardiac tamponade. No postoperative same admission recurrences were reported and 11 (24.4%) mortalities were recorded, 7 (15.5%) cases of them </span><span><span style="font-family:Verdana;">were diagnosed as malignant effusions. </span><b><