| Pericardiectomy vs medical management in patients with relapsing pericarditis. | |
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MedLine Citation:
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PMID: 23127733 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 87 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-06 Completed Date: 2013-01-16 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: England |
Other Details:
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Languages: eng Pagination: 1062-70 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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1 UL1RR024150/RR/NCRR NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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