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Surgical Approaches in Constrictive Pericarditis

Relieving diastolic filling by surgically removing the thickened pericardium.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Surgical Approaches in Constrictive Pericarditis?

Surgical treatment of constrictive pericarditis removes the thickened, fibrotic and often calcified pericardium that surrounds the heart (pericardiectomy). Pericardial thickening restricts diastolic filling of the ventricles and causes heart failure symptoms.

The timing of pericardiectomy is critical; surgery performed early (before myocardial atrophy develops) yields better outcomes. Benefit is limited when advanced myocardial fibrosis and atrophy are already present.

The surgical approach is usually median sternotomy with total or subtotal pericardiectomy. Preservation of the phrenic nerves is critical during surgery.

Perioperative mortality ranges from 5–10% and is lower in experienced centers. Long-term outcomes depend on timing of surgery and underlying etiology.

Symptoms

Features suggesting need for pericardiectomy:
Progressive dyspnea and exercise intolerance
Abdominal swelling (ascites) and leg edema
Elevated jugular venous pressure
Hepatomegaly and hepatic congestion
Diuretic-resistant edema

Risk Factors

Advanced myocardial atrophy (reduces surgical success)
Radiation-induced constrictive pericarditis (poor prognosis)
Perioperative low cardiac output syndrome
Bleeding and infection risk
Phrenic nerve injury

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Progressive right heart failure despite medical therapy
  • Surgical evaluation after a diagnosis of constrictive pericarditis
  • New symptoms or suspected recurrence after pericardiectomy

Treatment Methods

01
Total or subtotal pericardiectomy (median sternotomy)
02
Preoperative hemodynamic optimization
03
Postoperative ICU care and fluid management
04
Anti-inflammatory therapy for transient inflammatory constriction
05
Treatment of the underlying etiology (tuberculosis, autoimmune)
06
Long-term echocardiographic and clinical follow-up

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.