Treatment Options for Pericarditis Surgery

Pericarditis, an inflammation of the pericardium, can sometimes require surgical intervention, especially when complications such as cardiac tamponade or chronic constrictive pericarditis develop. Below are the most commonly used surgical approaches to treat pericarditis effectively.

Pericardiocentesis: A Minimally Invasive Diagnostic and Therapeutic Procedure

Pericardiocentesis is often the first-line surgical procedure for patients with significant pericardial effusion. This technique involves inserting a needle into the pericardial space to remove excess fluid. The extracted fluid can be analyzed to determine whether the pericarditis is caused by infection, malignancy, or other underlying conditions.

When fluid buildup exerts pressure on the heart—leading to symptoms like low blood pressure, shortness of breath, or even pulmonary edema—pericardiocentesis can provide rapid relief by reducing the pressure around the heart. In some cases, antibiotics or other medications may be introduced directly into the pericardial cavity to treat infections or reduce inflammation.

Open Thoracotomy: Resolving Chronic or Constrictive Pericarditis

For patients suffering from chronic or constrictive pericarditis, a more invasive surgical approach may be necessary. This includes a thoracotomy, where surgeons access the heart either through the sternum or between the ribs. The procedure typically involves complete or partial removal of the inflamed pericardium—a process known as pericardiectomy.

By removing the rigid or inflamed pericardial tissue, this surgery helps restore normal heart function and alleviate symptoms such as fatigue, swelling, and difficulty breathing. It is particularly effective in cases where the pericardium has become thickened and is restricting the heart's ability to expand and contract properly.

Choosing the Right Surgical Option

The choice of surgical treatment depends on several factors including the severity of symptoms, the underlying cause of pericarditis, and the patient's overall health. Doctors will evaluate each case individually to determine whether a less invasive procedure like pericardiocentesis is sufficient or if a more definitive surgery like pericardiectomy is required.