Konstriktif Perikarditin Cerrahi Tedavisi: Tek Merkezli Bir Deneyim

Abstract

Giriş: Konstriktif perikardit (KP) nadir ve potansiyel olarak ölümcül bir hastalıktır. Sağ kalp yetmezliğinin önemli nedenlerinden biridir ve acil müdahale gerektirir. Bu çalışmanın amacı, hastane merkezimizde KP nedeniyle ameliyat edilen hastaların kısa ve orta dönem sonuçlarını araştırmaktır.

Hastalar ve Yöntem: Merkezimizde KP nedeniyle perikardiyektomi uygulanan 27 hastanın verileri değerlendirildi. Klinik bulgular, görüntüleme modaliteleri, cerrahi teknik ve takip sonuçları retrospektif olarak değerlendirildi.

Bulgular: Hastalarımızın yaş ortalaması 49.78 idi. Hastalarımızın en sık görülen semptomu dispne idi. Fiziksel muayene sırasında periferik ödem en sık görülen işaretti. Ortalama perikardiyum kalınlığı 3.4 mm ile 6.6 mm arasında değişmekteydi. Toplam 15 (%55.6) hastada perikardiyektomi, 12 (%44.4) hastada parsiyel perikardiyektomi uygulandı. Eşlik eden kardiyak cerrahi ile perikardiyektomi 5 (%18.5) hastada perfüze edildi. Maalesef postoperatif mortalite 4 (%14.8) hastada meydana geldi.

Sonuç: Perikardın cerrahi olarak çıkarılması, bazı serilerde bildirilen yüksek mortalite oranlarına rağmen KP'li hastalarda tercih edilmesi gereken bir tedavi yöntemidir.

Keywords

• Konstriktif perikardit,perikardiyektomi,mortalite

Surgical Treatment of Constrictive Pericarditis: a Single-Center Experience

Abstract

Introduction: Constrictive pericarditis (CP) is a rare and potentially lethal disease. It is one of the important reasons of the right-sided heart failure, and it requires immediate intervention. The aim of this study was to investigate the short-term and mid-term results in patients who were operated for CP in our hospital center.

Patients and Methods: We evaluated data of 27 patients who underwent pericardiectomy due to CP in our center. Clinical findings, results of imaging modalities, the surgical technique, and the follow-up were retrospectively evaluated.

Results: The mean age of our patients was 49.78 years. The most common symptom was dyspnea. Peripheral edema was the most common sign during the physical examination. The mean pericardium thickness ranged between 3.4 mm and 6.6 mm in diameter. Total pericardiectomy was performed in 15 patients (55.6%), while partial pericardiectomy was performed in 12 patients (44.4%). Pericardiectomy with concomitant cardiac surgery was performed in 5 patients (18.5%). Unfortunately, postoperative mortality occurred in 4 patients (14.8%).

Conclusion: Surgical removal of pericardium is a treatment modality that should be preferred in patients with CP, despite high mortality rates reported in some series.

Keywords

• Constrictive pericarditis,pericardiectomy,mortality

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