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Heart Disease (Expert Forum)
Pericardiectomy
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Doctor's Answer
by CCF Cardio MD - MTR, Jul 22, 1998 12:00AM
Dear K. Goldman, thank you for your question. First, the indication for the
procedure would have to be known to answer your question completely. For the
meantime, I'll assume that you're talking about constrictive pericarditis which
is the common indication for a complete pericardiectomy. The pericardium is
a sac which surrounds the heart and is filled with a viscous fluid that lubricates
the outside of the heart to allow for efficient contractions. After a bout of
pericarditis (inflammation of the pericardium caused by infection, autoimmune
disorders, open heart surgery, etc.), the pericardium becomes thickened and can
adhere to the outer surface of the heart. When this is severe, constrictive
pericarditis develops which is manifest as right heart failure. In right
heart failure, blood backs up into the liver causing abdominal fluid retention
and distension, elevated venous pressure, and shortness of breath. Right
heart failure results because blood returning to the right side of the heart
does not sufficiently empty into the heart since the thickened pericardium constrains
the right ventricle from expanding enough to receive the venous blood. A
complete pericardiectomy can be done by a cardiac surgeon who would manually
strip the entire pericardium off the outer surface of the heart. This is a major
surgery however, and can be difficult to perform since the pericardium may be
densely adhered to the outer surface of the heart. I can't quote you success
rates of the surgery, however, because the patients that have this procedure done
are so heterogenous that comparisons are difficult. I hope you find this information
useful.
Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.
