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Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia

Received: 31 May 2024     Accepted: 3 September 2024     Published: 26 September 2024
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Abstract

Background: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. Objective: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were operated at Tikur Anbessa Specialized Hospital from 2014 - 2022. Methods: A retrospective study was done among 65 patients. Data was presented using frequencies with percentages, mean (±standard deviation) and/ or median (interquartile range) as required. Perioperative mortality and complications were summarized using incidence density with 95% confidence interval (CI). Result: Most patients were in their 20s (53.8%) and where male are (84.6%). The commonest presenting symptom was shortness of breath (100%), fatiguability (96.9%), and coughs (66.2%). The median time of presentation was 12.3 months (IQR, 7.0-25.5). There were also cases with clinical symptoms of tuberculosis (13.8%). The etiology of constrictive pericarditis was infectious in 83.1% of cases. The mean length of surgery was 3.3 ± 0.6 hours. The median duration of hospital stay is 9.0 days (IQR, 7.0-12.0). The incidence rate (IR) of perioperative death was 7.9 per 1000 person-days (PD) of observation (94% CI = 3.3 – 19.2) and the incidence rate of complication was 4.8 per 1000 PD (95% CI = 1.5 -14.9). Conclusion: Pericardiectomy is the best treatment for patients with constrictive pericarditis. The majority of patients had a good outcome, with an improvement in symptoms and functional status. The mortality rate was low, and the complication rate was acceptable. However, this study is based on relatively small sample size, and it is a retrospective study from a single center. Hence, further prospective studies are needed to confirm the findings of this study.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 10, Issue 3)
DOI 10.11648/j.ijcts.20241003.12
Page(s) 36-45
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pericardiectomy, Constrictive Pericarditis, Out Come

References
[1] Faiza Z, Prakash A, Namburi N, Johnson B, Timsina L, Lee LS. Fifteen-year experience with pericardiectomy at a tertiary referral center. J Cardiothorac Surg. 2021 Jun 22; 16(1): 180.
[2] George, T. J., Arnaoutakis, G. J., Beaty, C. A., Kilic, A., Baumgartner, W. A., & Conte, J. V. (2012). Contemporary etiologies, risk factors, and outcomes after pericardiectomy. The Annals of thoracic surgery, 94(2), 445–451.
[3] Gillaspie EA, Stulak JM, Daly RC, Greason KL, Joyce LD, Oh J, Schaff HV, Dearani JA. A 20-year experience with isolated pericardiectomy: Analysis of indications and outcomes. J Thorac Cardiovasc Surg. 2016 Aug; 152(2): 448-58.
[4] DeValeria PA, Baumgartner WA, Casale AS, Greene PS, Cameron DE, Gardner TJ, Gott VL, Watkins L Jr, Reitz BA. Current indications, risks, and outcome after pericardiectomy. Ann Thorac Surg. 1991 Aug; 52(2): 219-24.
[5] Vistarini N, Chen C, Mazine A, Bouchard D, Hebert Y, Carrier M, Cartier R, Demers P, Pellerin M, Perrault LP. Pericardiectomy for Constrictive Pericarditis: 20 Years of Experience at the Montreal Heart Institute. Ann Thorac Surg. 2015 Jul; 100(1): 107-13.
[6] Murashita T, Schaff HV, Daly RC, Oh JK, Dearani JA, Stulak JM, King KS, Greason KL. Experience With Pericardiectomy for Constrictive Pericarditis Over Eight Decades. Ann Thorac Surg. 2017 Sep; 104(3): 742-750.
[7] Avgerinos D, Rabitnokov Y, Worku B, Neragi-Miandoab S, Girardi LN. Fifteen-year experience and outcomes of pericardiectomy for constrictive pericarditis. J Card Surg. 2014 Jul; 29(4): 434-8.
[8] Miranda WR, Oh JK. Constrictive Pericarditis: A Practical Clinical Approach. Prog Cardiovasc Dis. 2017 Jan-Feb; 59(4): 369-379.
[9] Bertog SC, Thambidorai SK, Parakh K, Schoenhagen P, Ozduran V, Houghtaling PL, Lytle BW, Blackstone EH, Lauer MS, Klein AL. Constrictive pericarditis: etiology and cause-specific survival after pericardiectomy. J Am Coll Cardiol. 2004 Apr 21; 43(8): 1445-52.
[10] Szabó G, Schmack B, Bulut C, Soós P, Weymann A, Stadtfeld S, Karck M. Constrictive pericarditis: risks, aetiologies, and outcomes after total pericardiectomy: 24 years of experience. Eur J Cardiothorac Surg. 2013 Dec; 44(6): 1023-8; discussion 1028.
[11] Busch C, Penov K, Amorim PA, Garbade J, Davierwala P, Schuler GC, Rastan AJ, Mohr FW. Risk factors for mortality after pericardiectomy for chronic constrictive pericarditis in a large single-centre cohort. Eur J Cardiothorac Surg. 2015 Dec; 48(6): e110-6.
[12] Mori M, Mullan CW, Bin Mahmood SU, Yousef S, Pelletier KJ, Mangi AA, Geirsson A. US National Trends in the Management and Outcomes of Constrictive Pericarditis: 2005-2014. Can J Cardiol. 2019 Oct; 35(10): 1394-1399.
[13] Kumawat M, Lahiri TK, Agarwal D. Constrictive pericarditis: retrospective study of 109 patients. Asian Cardiovasc Thorac Ann. 2018 Jun; 26(5): 347-352.
[14] Gatti G, Fiore A, Ternacle J, Porcari A, Fiorica I, Poletti A, Ecarnot F, Bussani R, Pappalardo A, Chocron S, Folliguet T, Perrotti A. Pericardiectomy for constrictive pericarditis: a risk factor analysis for early and late failure. Heart Vessels. 2020 Jan; 35(1): 92-103.
[15] Biçer M, Özdemir B, Kan İ, Yüksel A, Tok M, Şenkaya I. Long-term outcomes of pericardiectomy for constrictive pericarditis. J Cardiothorac Surg. 2015 Nov 27; 10: 177.
[16] Nozohoor S, Johansson M, Koul B, Cunha-Goncalves D. Radical pericardiectomy for chronic constrictive pericarditis. J Card Surg. 2018 Jun; 33(6): 301-307.
[17] Nishimura S, Izumi C, Amano M, Imamura S, Onishi N, Tamaki Y, Enomoto S, Miyake M, Tamura T, Kondo H, Kaitani K, Yamanaka K, Nakagawa Y. Long-Term Clinical Outcomes and Prognostic Factors After Pericardiectomy for Constrictive Pericarditis in a Japanese Population. Circ J. 2017 Jan 25; 81(2): 206-212.
[18] Zhu P, Mai M, Wu R, Lu C, Fan R, Zheng S. Pericardiectomy for constrictive pericarditis: single-center experience in China. J Cardiothorac Surg. 2015 Mar 19; 10: 34.
[19] Choi MS, Jeong DS, Oh JK, Chang SA, Park SJ, Chung S. Long-term results of radical pericardiectomy for constrictive pericarditis in Korean population. J Cardiothorac Surg. 2019 Feb 6; 14(1): 32.
[20] Kang SH, Song JM, Kim M, Choo SJ, Chung CH, Kang DH, Song JK. Prognostic predictors in pericardiectomy for chronic constrictive pericarditis. J Thorac Cardiovasc Surg. 2014 Feb; 147(2): 598-605.
[21] Acharya A, Koirala R, Rajbhandari N, Sharma J, Rajbanshi B. Anterior Pericardiectomy for Postinfective Constrictive Pericarditis: Intermediate-Term Outcomes. Ann Thorac Surg. 2018 Oct; 106(4): 1178-1181.
[22] Jaiswal LS, Pandit N, Sah B. Surgical treatment of tuberculous chronic constrictive pericarditis: A retrospective observational study from tertiary hospital of eastern Nepal. Indian J Tuberc. 2021 Apr; 68(2): 174-178.
[23] Fang L, Yu G, Huang J, Zhao W, Ye B. Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis. J Cardiothorac Surg. 2020 Jun 19; 15(1): 148.
[24] Adem Ali, H. Biluts, A. Bekele. Thoracic surgical unit, Tikur Anbessa Hospital, Department of Surgery, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia Vol. 12 No. 1 (2007).
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    F. Senbu, M., Desalegn, A. B., Mideksa, D. T. (2024). Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia. International Journal of Cardiovascular and Thoracic Surgery, 10(3), 36-45. https://doi.org/10.11648/j.ijcts.20241003.12

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    ACS Style

    F. Senbu, M.; Desalegn, A. B.; Mideksa, D. T. Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia. Int. J. Cardiovasc. Thorac. Surg. 2024, 10(3), 36-45. doi: 10.11648/j.ijcts.20241003.12

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    AMA Style

    F. Senbu M, Desalegn AB, Mideksa DT. Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia. Int J Cardiovasc Thorac Surg. 2024;10(3):36-45. doi: 10.11648/j.ijcts.20241003.12

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  • @article{10.11648/j.ijcts.20241003.12,
      author = {Mekonnen F. Senbu and Admikew Bekele Desalegn and Demu Tesfaye Mideksa},
      title = {Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia
    },
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {10},
      number = {3},
      pages = {36-45},
      doi = {10.11648/j.ijcts.20241003.12},
      url = {https://doi.org/10.11648/j.ijcts.20241003.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20241003.12},
      abstract = {Background: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. Objective: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were operated at Tikur Anbessa Specialized Hospital from 2014 - 2022. Methods: A retrospective study was done among 65 patients. Data was presented using frequencies with percentages, mean (±standard deviation) and/ or median (interquartile range) as required. Perioperative mortality and complications were summarized using incidence density with 95% confidence interval (CI). Result: Most patients were in their 20s (53.8%) and where male are (84.6%). The commonest presenting symptom was shortness of breath (100%), fatiguability (96.9%), and coughs (66.2%). The median time of presentation was 12.3 months (IQR, 7.0-25.5). There were also cases with clinical symptoms of tuberculosis (13.8%). The etiology of constrictive pericarditis was infectious in 83.1% of cases. The mean length of surgery was 3.3 ± 0.6 hours. The median duration of hospital stay is 9.0 days (IQR, 7.0-12.0). The incidence rate (IR) of perioperative death was 7.9 per 1000 person-days (PD) of observation (94% CI = 3.3 – 19.2) and the incidence rate of complication was 4.8 per 1000 PD (95% CI = 1.5 -14.9). Conclusion: Pericardiectomy is the best treatment for patients with constrictive pericarditis. The majority of patients had a good outcome, with an improvement in symptoms and functional status. The mortality rate was low, and the complication rate was acceptable. However, this study is based on relatively small sample size, and it is a retrospective study from a single center. Hence, further prospective studies are needed to confirm the findings of this study.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia
    
    AU  - Mekonnen F. Senbu
    AU  - Admikew Bekele Desalegn
    AU  - Demu Tesfaye Mideksa
    Y1  - 2024/09/26
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ijcts.20241003.12
    DO  - 10.11648/j.ijcts.20241003.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 36
    EP  - 45
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20241003.12
    AB  - Background: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. Objective: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were operated at Tikur Anbessa Specialized Hospital from 2014 - 2022. Methods: A retrospective study was done among 65 patients. Data was presented using frequencies with percentages, mean (±standard deviation) and/ or median (interquartile range) as required. Perioperative mortality and complications were summarized using incidence density with 95% confidence interval (CI). Result: Most patients were in their 20s (53.8%) and where male are (84.6%). The commonest presenting symptom was shortness of breath (100%), fatiguability (96.9%), and coughs (66.2%). The median time of presentation was 12.3 months (IQR, 7.0-25.5). There were also cases with clinical symptoms of tuberculosis (13.8%). The etiology of constrictive pericarditis was infectious in 83.1% of cases. The mean length of surgery was 3.3 ± 0.6 hours. The median duration of hospital stay is 9.0 days (IQR, 7.0-12.0). The incidence rate (IR) of perioperative death was 7.9 per 1000 person-days (PD) of observation (94% CI = 3.3 – 19.2) and the incidence rate of complication was 4.8 per 1000 PD (95% CI = 1.5 -14.9). Conclusion: Pericardiectomy is the best treatment for patients with constrictive pericarditis. The majority of patients had a good outcome, with an improvement in symptoms and functional status. The mortality rate was low, and the complication rate was acceptable. However, this study is based on relatively small sample size, and it is a retrospective study from a single center. Hence, further prospective studies are needed to confirm the findings of this study.
    
    VL  - 10
    IS  - 3
    ER  - 

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