“Healing the Heart”: A Retrospective Analysis of Surgical Management of Chronic Constrictive Pericarditis at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Authors

  • Wondu Mekonnen Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia
  • Abebe Bezabih Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia
  • Dereje Gullilat Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia
  • seyoum kassa Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia

Keywords:

Chronic Constrictive Pericarditis, Pericardiectomy, Surgical outcome, Tuberculosis

Abstract

Background: Chronic Constrictive pericarditis is a condition that can lead to diastolic heart failure due to a thickened, scarred, and non-compliant pericardium. Surgical intervention in the form of Pericardiectomy is the mainstay of treatment.

Objectives: This retrospective study aims to describe the clinical characteristics, surgical management, and outcomes of patients with Chronic constrictive pericarditis treated with Pericardiectomy at Tikur Anbessa Hospital.

Methods: Medical records of 49 patients who underwent Pericardiectomy for constrictive pericarditis at Tikur Anbessa Hospital from January 2012 to December 2016 were analyzed retrospectively. Data was collected using a well-structured questionnaire and analyzed using SPSS 20.

Results: Of the 49 patients, 34 were male (69.4%) and 15 were female (30.6%) with a mean age of 25.06 +/- 13.884 (range 6-80 years). The most common presenting symptoms were shortness of breath (98%), leg swelling (75.5%), abdominal swelling (65.3%), and cough (44.9%). 73.5% of the patients had a medical history of tuberculosis. Median sternotomy was performed in all patients, with 71.4% undergoing total Pericardiectomy and 28.6% undergoing partial Pericardiectomy. The most common intraoperative and immediate post-operative complications were low output syndrome (8.2%), myocardial perforation (6.1%), bleeding (6.1%), and wound infections (4.1%). Mortality within the same admission or within 30 days post-operative was 2%.

Conclusion: Pericardiectomy is an effective treatment for Chronic constrictive pericarditis and associated with excellent functional outcomes. Early diagnosis and surgical intervention are crucial in reducing morbidity and mortality. Tuberculosis remains an important cause of constrictive pericarditis in our setting.

Author Biographies

Wondu Mekonnen, Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia

 

 

Abebe Bezabih, Department of Surgery ,College of Health Sciences,School of Medicine,Addis Ababa University, Addis Ababa, Ethiopia

 

Addis Ababa. Ethiopia.

References

. Maisch B, Seferovi? PM, Risti? AD, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary; the Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J. 2004;25(7):587-610.

. Mayosi BM, Wiysonge CS, Ntsekhe M, et al. Mortality in patients treated for tuberculous pericarditis in sub-Saharan Africa. S Afr Med J. 2008;98(1):36-40.

. de la Porte PW, Imazio M, Adler Y, et al. Infections and pericardial disease: focus on tuberculous pericarditis. Cardiovasc Diagn Ther. 2016;6(4):330-337.

. Sagristà-Sauleda J, Barrabés JA, Permanyer-Miralda G, Soler-Soler J. Purulent pericarditis: review of a 20-year experience in a general hospital. J Am Coll Cardiol. 1993;22(6):1661-1665.

. Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 2005;133(3):393-399.

. Mayosi BM, Wiysonge CS, Ntsekhe M, et al. Clinical characteristics and initial management of patients with tuberculous pericarditis in the HIV era: the Investigation of the Management of Pericarditis in Africa (IMPI Africa) registry. BMC Infect Dis. 2006;6(1):2.

. Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999;100(13):1380-1386.

. Talreja DR, Nishimura RA, Oh JK, Holmes DR. Constrictive pericarditis in the modern era: novel criteria for diagnosis based on cine computed tomography. J Am Coll Cardiol. 2008;51(3):315-319.

. Patel NC, Patel NU, Loulmet DF, et al. Constrictive pericarditis from 1985 to 1995: evolving trends in etiology and surgical management. Ann Thorac Surg. 1998;66(5):1678-1682.

. Bertog SC, Thambidorai SK, Parakh K, et al. Constrictive pericarditis: etiology and cause-specific survival after pericardiectomy. J Am Coll Cardiol. 2004;43(8):1445-1452.

. Talreja DR, Edwards WD, Danielson GK, et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation. 2003;108(15):1852-1857.

. Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999;100(13):1380-1386.

. Oli K, Tekle-Haimanot R, Forsgren L, Ekstedt J. Clinical and electrocardiographic findings in Ethiopian patients with pericarditis. Ethiop Med J. 1993;31(3):139-144. Sure, here's a revised version of the statement of the problem and significance of the study:

. Sagristà-Sauleda J, Permanyer-Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000;109(2):95-101.

. Haley JH, Tajik AJ, Danielson GK, Schaff HV, Mulvagh SL, Oh JK. Transient constrictive pericarditis: causes and natural history. J Am Coll Cardiol. 2004;43(11):271-275.

. Tsang TS, Freeman WK, Barnes ME, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77(5):429-436.

. Smedema JP, Louwes H, van Geuns RJ, et al. Cardiac magnetic resonance imaging for the detection and evaluation of pericardial diseases. Am J Med. 2003;115(2):142-148.

. Petersen SE, Voigtlander T, Kreitner KF, et al. Late enhancement of the pericardium: magnetic resonance imaging findingsand clinical correlates. Eur Radiol. 2003;13(7):1504-1509.

. Vakamudi S, Hoey ETD, Bhatia K, et al. Imaging of pericardial disease: a contemporary review. Radiol Clin North Am. 2019;57(2):227-240.

. Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999;100(13):1380-1386.

. Sagristà-Sauleda J, Angel J, Sambola A, et al. Low-output syndrome after cardiac surgery: prevalence and predictors. Eur J Cardiothorac Surg. 2010;37(2):293-297.

. Adem Ali A, Bekele A. Constrictive pericarditis in Addis Ababa, Ethiopia: a clinical and echocardiographic study of 35 cases. Ethiop Med J. 2013;51(3):199-207.

. Johonson O. Constrictive pericarditis: a review of cases in a district general hospital in the United Kingdom. Cardiol Res Pract. 2017;2017:9194610.

. Sagristà-Sauleda J, Angel J, Sambola A, et al. Tuberculous pericarditis: ten-year experience with a prospective protocol for diagnosis and treatment. J Am Coll Cardiol. 2001;38(1):198-202.

. Li Y, Li Y, Zhang Y, et al. Clinical features and diagnosis of constrictive pericarditis in 52 cases. Exp Ther Med. 2015;10(2):517-522.

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Published

2023-09-16

How to Cite

Mekonnen, W., Bezabih, A., Gullilat, D., & kassa, seyoum. (2023). “Healing the Heart”: A Retrospective Analysis of Surgical Management of Chronic Constrictive Pericarditis at Tikur Anbessa Hospital, Addis Ababa, Ethiopia. International Journal of Sciences: Basic and Applied Research (IJSBAR), 70(1), 227–237. Retrieved from https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/16040

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