Disease relevance of Pericardiectomy

• During follow-up, 2 (4%) of the 53 prednisolone and 7 (11%) of the 61 placebo patients died from pericarditis, and 11 (21%) and 18 (30%), respectively, required pericardiectomy [1].
• CONCLUSIONS: In this model of tissue repair, increased AT1 receptor binding density is associated with ACE binding and fibrillar collagen formation that appears within sites of fibrous tissue formation, including myocardial infarction, endocardial fibrosis, foreign body (silk suture), and pericardiotomy [2].
• Cardiac tamponade in systemic juvenile rheumatoid arthritis requiring emergency pericardiectomy [3].
• Another patient whose CVP of 30 cm H2O showed no change after parietal pericardiectomy was thought to have amyloid cardiomyopathy but instead at autopsy had constrictive epicardial sclerosis not recognized at parietal pericardiectomy [4].
• He had uneventful pericardectomy, and post-operatively the chylothorax resolved only after administration of octreotide for 10 days [5].

High impact information on Pericardiectomy

• These changes disappeared after pericardiectomy and were not seen in patients with restrictive cardiomyopathy or in normal subjects [6].
• After pericardiectomy the pressure-segment length data during control, volume loading and sodium nitroprusside fell on a single curve (intercepts and slopes not statistically different); After dextran infusion, intrapericardial pressure rose from control 1.5 +/- 0.7 mm Hg to 8.2 +/- 0.5 mm Hg, and it fell to 4.8 +/- 0.1 mm Hg after nitroprusside [7].
• Propranolol did not alter this nonuniform response, while pericardiectomy attenuated the regional variations [8].
• Treatment should include pericardectomy and immediate use of both ampicillin sodium and chloramphenicol sodium succinate, until the sensitivity of the organism is known [9].
• A combination of prolonged amphotericin B therapy and pericardiectomy appears to be the best approach for achieving a cure [10].

Chemical compound and disease context of Pericardiectomy

• Local steroid instillation versus pericardiectomy for intractable pericardial effusion: the problem revisited through a multi-institutional study [11].
• Further local treatment, for those patients who develop recurrent cardiac tamponade after an initial drainage procedure, may include tetracycline sclerosis of the pericardial space, instillation of cancer chemotherapeutic agents, radiation therapy, and pericardiectomy [12].
• Although pericardiectomy has been performed for constrictive pericarditis without exception, it also plays an important role in the treatment of chronic exsudative pericarditis, especially for cholesterin or tuberculous pericarditis [13].

Biological context of Pericardiectomy

• Nitroprusside did not alter the time course of left ventricular pressure fall during the isovolumic period of diastole either before pericardiectomy (28.8 +/- 10.2 sec,-1, 28.4 +/- 11.9 sec-1) or after (28.8 +/- 6.7 sec-1, 26.1 +/- 7.2 sec-1) [14].

Anatomical context of Pericardiectomy

• Simultaneous left ventriculograms and pressures were obtained before and during nitroprusside infusion with the pericardium intact and in four dogs the studies were repeated 7 to 15 days after pericardiectomy [14].
• Because of multiple complications generated by the steroid administration, she underwent coronary angiography followed by pericardiectomy and coronary artery bypass surgery [15].
• The effect of nitroprusside on the human left ventricle after pericardiotomy has not been reported [16].

Associations of Pericardiectomy with chemical compounds

• In our experience, the invasive intervention of choice is either formal pericardiectomy or subxiphoid pericardiotomy with intrapericardial steroid instillation [17].
• We compared the influence of the pericardium on left and right ventricular (LV, RV) filling by measuring LV and RV pressures and segment lengths (SL, LV free wall, and RV inflow and outflow tracts) in six open-chest, pentobarbital sodium-anesthetized dogs before and after pericardiectomy [18].
• Because of unsuccessful conservative treatment (pericardiocentesis, pericardial drainage, low-fat diet with medium-chain triglycerides, and total parenteral nutrition), surgical intervention was indicated and the patient successfully underwent right-sided thoracoscopic duct ligation and partial pericardiectomy (pericardial window) [19].
• Before induction of anaesthesia, at pericardiotomy, then at 1, 10, 20 and 30 min after CPB, haemodynamic profiles, haematocrit, and O2 saturation of arterial and mixed venous blood were measured [20].
• The haemodynamic variables were measured: just before the start of milrinone or normal saline after pericardiotomy (baseline value); 10 min after the tissue stabilizer had been applied for the anastomosis of left anterior descending artery, left circumflex artery and right coronary artery; and after the sternal closure [21].

Gene context of Pericardiectomy

• Immediate and lasting relief of this unusual nonarticular manifestation of rheumatoid arthritis can be expected after pericardiectomy [22].
• Pericardiotomy showed the catheter transversing the pericardial sac just beneath an unusual high reflection and then reentering the superior vena cava [23].
• The measurements were then repeated following pericardiotomy by a midline incision [24].
• Right atrial biopsies were taken from 13 patients before and after CPB/CBC: after pericardiotomy, immediately after aortic cross-clamp removal, and following termination of CPB/CBC [25].
• Total pericardiectomy and repair of the ventricular septal defect resulted in a satisfactory outcome [26].

Analytical, diagnostic and therapeutic context of Pericardiectomy

• We conclude that a poor hemodynamic result after complete pericardiectomy relates to the preoperative degree of constriction and resultant cardiomyopathy [27].
• Pentobarbital-anesthetized rabbits underwent a left thoracotomy and pericardiotomy [28].
• After pericardiectomy, the repeat thallium stress test was normal [29].
• METHODS AND RESULTS: Normal mongrel canines (n=24) were divided into 4 groups consisting of anesthesia alone (control group); pericardiotomy (pericardiotomy group); lateral right atriotomy (atriotomy group); and lateral right atriotomy with antiinflammatory therapy (methylprednisolone 2 mg/kg per day) (antiinflammatory group) [30].
• We conclude that pericardiectomy using midline sternotomy with or without cardiopulmonary bypass can be performed safely and can lead to good functional results and long-term survival [31].

References