Pericardiectomy is a surgery that involves removing the inflamed pericardium (a double-walled membrane sac covering an outer surface of the heart). Pericarditis is manifested with chest discomfort and accumulation of fluid in the pericardial cavity.
Pericarditis is an acute or chronic inflammatory condition of the pericardium. It causes chest discomfort and the accumulation of fluid in the pericardial cavity which leads to pericardial tamponade.
Pericarditis can be:
Inflammation of the pericardium can be:
Infectious lesions include pericarditis when:
Also, pericarditis can result from drug allergies or serum sickness. Aseptic inflammation is formed as a result of:
The signs of pericarditis depend on the form and stage of the process.
Acute pericardial inflammation usually produces fibrin secretions, and as the process develops, inflammatory fluid accumulates.
Medications help to combat recurrent chronic pericarditis, purulent pericarditis, and constrictive pericarditis. For severe symptoms of the disease, a doctor suggests pericardiectomy. In some cases, pericarditis can cause an effusion into the bursa. It is a buildup of fluid in the pericardium that prevents the heart from contracting normally. In this case, the patient may need a pericardiectomy. It helps remove excess fluid and prevent it from returning.
Pericardiectomy is necessary for people with chronic and constrictive pericarditis. It is usually not an option for those who have had a single case of pericarditis that can be treatable with medication. In severe cases, surgical treatment is inevitable.
The surgery is not performed on patients with myocardial fibrosis. It is one of the primary causes of death during surgery. Therefore, it is necessary to undergo a thorough examination before the intervention. A doctor also avoids the surgical procedure for people with pericardial calcification, renal failure, oncology, severe disorders of the respiratory and nervous systems. Pericardiectomy is contraindicated in elderly patients (over 80 years old) and patients who have received radiation therapy.
8-12 hours before the operation, the patient should stop eating and drinking. It is necessary to adhere to a healthy diet a few weeks before the surgery. It helps to reduce the load on the heart. Also, before pericardiectomy, you cannot take any medications without a doctor’s consultation. Before pericardiectomy, the patient undergoes multiple examinations to identify possible contraindications and complications. These diagnostic procedures include:
A pericardiectomy is an operation performed under general anesthesia. If necessary, the patient may be connected to artificial ventilation. The surgeon makes an incision above the sternum or between the ribs to gain access to the heart. Then he removes all or part of the pericardium and closes the wound.
Several small incisions on the side of the chest may also be used to access the pericardium. This pericardiectomy technique is called thoracoscopy or VATS. It is performed without opening the chest using microsurgical instruments and small video cameras that transmit an image of the operated area to a monitor. In this case, all adhesions are separated by a laser. Drainage catheters are installed for several days to ensure normal drainage of fluid post-surgery and minimize the risks of bleeding in the anterior mediastinum.
The duration of the surgery depends on the severity of the disease and the method of performing a surgical procedure. Roughly, pericardiectomy lasts from 2 to 4 hours (longer in severe cases).
Pericardiectomy is a complicated surgical procedure, so the risks of complications, although rare, are possible. The main negative consequences of the surgery include:
Risks may vary depending on the patient’s age, general health, and the reason for the procedure. The complications are influenced by the heart condition, the structure, and the volume of fluid in the heart bag.
Post-surgery, the patient is placed in an intensive care unit. Then, in the absence of complications and stabilization of the condition, it is transferred to the usual one. During this period, the patient can be prescribed heart disease drugs and medications, pain relievers, and antibiotics. Typically, stitches or staples are removed 7-10 days after surgery. For a speedy recovery, it is necessary to avoid lifting weights and taking adequate rest. Also, adhere to a diet and all doctor’s recommendations regarding exercise and wound care. Full recovery of the body after pericardiectomy occurs after 3-5 months.
The cost of an operation to remove the inflamed membranes of the heart depends on:-
To prevent the development of inflammation, you need to:-
Pericardiectomy is a direct surgical approach to treat pericarditis. It successfully clears the heart bag from purulent masses, calcified areas, and fibrous adhesions. A month after surgery, the patient’s condition improves significantly. After 3-5 months, normal heart function fully restores.