Document Detail

Pericardiectomy vs medical management in patients with relapsing pericarditis.
MedLine Citation:
PMID:  23127733     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether surgical pericardiectomy is a safe and effective alternative to medical management for chronic relapsing pericarditis.
PATIENTS AND METHODS: Retrospective review of 184 patients presenting to the Mayo Clinic in Rochester, Minnesota, from January 1, 1994, through December 31, 2005, with persistent relapsing pericarditis identified 58 patients who had a pericardiectomy after failed medical management and 126 patients who continued with medical treatment only. The primary outcome variables were in-hospital postoperative mortality or major morbidity, all-cause death, time to relapse, and medication use.
RESULTS: Mean ± SD follow-up was 5.5 ± 3.5 years in the surgical group and 5.4 ± 4.4 years in the medical treatment group. At baseline, patients in the surgical group had higher mean relapses (6.9 vs 5.5; P=.01), were more likely to be taking colchicine (43.1% [n=25] vs 18.3% [n=23]; P=.002) and corticosteroids (70.7% [n=41] vs 42.1% [n=53]; P<.001), and were more likely to have undergone a prior pericardiotomy (27.6% [n=16] vs 11.1% [n=14]; P=.003) than the medical treatment group. Perioperative mortality (0%) and major morbidity (3%; n=2) were minimal. Kaplan-Meier analysis revealed no differences in all-cause death at follow-up (P=.26); however, the surgical group had a markedly decreased relapse rate compared with the medical treatment group (P=.009). Medication use was notably reduced after pericardiectomy.
CONCLUSION: In patients with chronic relapsing pericarditis in whom medical management has failed, surgical pericardiectomy is a safe and effective method of relieving symptoms.
Masud H Khandaker; Hartzell V Schaff; Kevin L Greason; Nandan S Anavekar; Raul E Espinosa; Sharonne N Hayes; Rick A Nishimura; Jae K Oh
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  87     ISSN:  1942-5546     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-01-16     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  England    
Other Details:
Languages:  eng     Pagination:  1062-70     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Chronic Disease
Follow-Up Studies
Middle Aged
Pericardiectomy / statistics & numerical data*
Pericarditis, Constrictive / epidemiology*,  surgery*
Pericarditis, Tuberculous / epidemiology*,  surgery*
Recurrence / prevention & control
Retrospective Studies
Severity of Illness Index*
Survival Analysis
Time Factors
Treatment Outcome
Grant Support

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