Constrictive Pericarditis Surgery Procedure

Understanding Constrictive Pericarditis Surgery

The primary surgical treatment for constrictive pericarditis is known as pericardiectomy or pericardial window procedure. This operation involves a thorough preoperative assessment followed by a median sternotomy or a left anterior thoracotomy approach under general anesthesia. The goal is to access the pericardial space and remove the thickened, fibrotic, and calcified pericardium that restricts normal heart function.

Step-by-Step Surgical Process

Unlike many cardiac procedures, this surgery typically does not require cardiopulmonary bypass or cardiac arrest. Surgeons carefully dissect and remove the affected pericardium around critical areas including the heart's surface, major vascular roots, apex, and diaphragmatic aspect. The complete removal of the diseased pericardium helps restore the heart's ability to expand and contract freely.

Challenges in Complex Cases

In some patients, especially those with long-standing or complicated disease, it may not be feasible to completely remove all affected pericardial tissue. In such situations, surgeons focus on excising the pericardium at key locations around the heart to relieve constriction and improve cardiac performance. After the procedure, the incision is carefully closed, and a drainage tube may be placed to remove excess fluid from the pericardial space.

Postoperative Care and Follow-Up

Successful recovery depends on comprehensive postoperative management. Patients are advised to undergo regular follow-up appointments to monitor for any recurrence or progression of pericardial disease. These evaluations are crucial for ensuring long-term cardiac health and preventing potential complications.