Document Detail


Pericardiectomy vs medical management in patients with relapsing pericarditis.
MedLine Citation:
PMID:  23127733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Masud H Khandaker; Hartzell V Schaff; Kevin L Greason; Nandan S Anavekar; Raul E Espinosa; Sharonne N Hayes; Rick A Nishimura; Jae K Oh
Related Documents :
8311803 - Chronic hepatic encephalopathy following portacaval shunt: management by loop ileostomy.
18464353 - Elimination of co-payment for weight management counseling. direct final rule.
19404893 - Evidence-based medicine teaching in uk medical schools.
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.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Echocardiography
Female
Follow-Up Studies
Hemodynamics
Humans
Male
Middle Aged
Minnesota
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
ID/Acronym/Agency:
1 UL1RR024150/RR/NCRR NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery ...
Next Document:  End-of-life care decisions: importance of reviewing systems and limitations after 2 recent North Ame...