Pericardiectomy vs Medical Management in Patients With Relapsing Pericarditis

Abstract 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, throug...

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Bibliographic Details
Published in:Mayo Clinic proceedings 2012-11, Vol.87 (11), p.1062-1070
Main Authors: Khandaker, Masud H., MD, PhD, Schaff, Hartzell V., MD, Greason, Kevin L., MD, Anavekar, Nandan S., MD, Espinosa, Raul E., MD, Hayes, Sharonne N., MD, Nishimura, Rick A., MD, Oh, Jae K., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Care and treatment
Chronic Disease
Diagnosis
Diseases of the pericardium
Echocardiography
Female
Follow-Up Studies
General aspects
Heart
Hemodynamics
Humans
Internal Medicine
Male
Medical sciences
Middle Aged
Minnesota
Original
Patient outcomes
Pericardiectomy - statistics & numerical data
Pericarditis
Pericarditis, Constrictive - epidemiology
Pericarditis, Constrictive - surgery
Pericarditis, Tuberculous - epidemiology
Pericarditis, Tuberculous - surgery
Retrospective Studies
Secondary Prevention
Severity of Illness Index
Survival Analysis
Time Factors
Treatment Outcome
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Summary:Abstract 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
ISSN:0025-6196
1942-5546
DOI:10.1016/j.mayocp.2012.05.024