Early and late results of pericardiectomy for XXXX .

@entity1 @entity296 @entity66 @entity998 @entity4 @entity3822 @entity843 @entity717 @entity204
Records of 231 @entity1 (171 males, 60 females; aged 10 months to 83 years [median 45 years]) who underwent operation for @entity3822 at the Mayo Clinic from 1936 through 1982 were reviewed. All had had hemodynamically significant pericardial constriction preoperatively, and @entity66 was confirmed at operation. Preoperatively, 69% were in New York Heart Association Class III or IV and 81% had peripheral @entity4 or @entity843 . Pericardiectomy was performed through a left anterolateral thoracotomy (34%), a median sternotomy (27%), a U incision (Harrington) (21%), or a bilateral anterior thoracotomy (18%). Postoperatively, 28% of @entity1 had evidence of @entity998 ; 70% of the 32 @entity204 within 30 days of operation were due to @entity998 . Operative risk was significantly (p less than 0.001) related to @entity717 (1% for Class I or II; 10% for class III; 46% for Class IV). Median postoperative follow-up was 9 years (longest was 43 years). Probability of survival for @entity1 dismissed alive from the hospital was 84% at 5 years, 71% at 15 years, and 52% at 30 years. Long-term survival (excluding operative mortality) was not significantly influenced by the disability class preoperatively, the operative approach, or the development of @entity998 in the immediate postoperative period. At the end of the follow-up interval, there were 141 @entity1 in whom functional capacity could be assessed; 140 were in Class I or II. We conclude that a poor hemodynamic result after complete pericardiectomy relates to the preoperative degree of constriction and resultant @entity296 . We recommend early pericardiectomy when pericardial constriction is diagnosed, and we continue to use a left anterolateral thoracotomy as the preferred approach for most @entity1 .
