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AbstractFrom 1970 to 1990, 71 consecutive patients (51 men and 20 women) hadpericardectomy for chronic constrictive pericarditis. The mean age was 44.2+/- 16.1 years. In the preoperative state 2.8% were in NYHA class I, 18.3%in II, 43.6% in III and 35.2% in IV. The operative approach was mediansternotomy in 93% and left anterolateral thoracotomy in 7%. The earlymortality rate (within 30 days after operation) was 5.6%. All four earlydeaths were female (P < 0.001), in the preoperative state the patientswere classified as NYHA class IV (P < 0.01). These patients had asignificantly higher preoperative mean right atrial pressure then survivors(21.5 +/- 8.5 mmHg vs 13.6 +/- 5.6 mmHg, P < 0.005). Follow-up wasobtained for 65 patients (91.5%) and averaged 11 +/- 5.8 years (the longestperiod was 21.5 years). Actuarial survival at 5, 10, 15 and 20 years forall patients was 84.6% +/- 4.5%, 80.1% +/- 5.3%, 70.5% +/- 6.9% and 65.8%+/- 7.9%, respectively. In the preoperative state 10 of the 12 late deaths(83%) were classified NYHA class IV and the remaining ones class III. Ofthe 49 patients alive 23% belong to NYHA class I, 42% to II and 35% to III;none is in class IV. Negative predictors of survival were found to bepreoperative NYHA class IV (P < 0.01), low-voltage electrocardiogram(ECG) (P < 0.01), ascites (P < 0.01), dyspnea at rest (P < 0.05)and hyperbilirubinemia (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Sep 1, 1994
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