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Title Futility of pericardiectomy for postirradiation constrictive pericarditis
Creator/Author Ni, Y. ; von Segesser, L.K. ; Turina, M. (University Hospital, Zuerich (Switzerland))
Publication Date1990 Mar 01
OSTI IdentifierOSTI ID: 6968147
Other Number(s)ISSN0003-4975; CODEN: ATHSA
Resource TypeJournal Article
Resource RelationAnnals of Thoracic Surgery ; Vol/Issue: 49:3
Subject560151 -- Radiation Effects on Animals-- Man; HODGKINS DISEASE-- RADIOTHERAPY;PERICARDIUM-- DELAYED RADIATION EFFECTS;RADIOTHERAPY-- SIDE EFFECTS; PATIENTS;RADIATION INJURIES;REVIEWS
Related SubjectBIOLOGICAL EFFECTS;BIOLOGICAL RADIATION EFFECTS;BODY;CARDIOVASCULAR SYSTEM;DISEASES;DOCUMENT TYPES;HEART;IMMUNE SYSTEM DISEASES;INJURIES;LYMPHOMAS;MEDICINE;MEMBRANES;NEOPLASMS;NUCLEAR MEDICINE;ORGANS;RADIATION EFFECTS;RADIOLOGY;SEROUS MEMBRANES;THERAPY
Description/Abstract Two patients underwent pericardiectomy for postirradiation constrictive pericarditis.^Both had received radiotherapy (more than 6,000 rads) for treatment of Hodgkin`s disease 17 (patient 2) and 20 years (patient 1) earlier.^At the time of operation, the patients were in New York Heart Association functional class III-IV or IV.^Preoperative catheterization showed the following pressures for patients 1 and 2, respectively: right atrial, 30 and 14 mm Hg; right ventricular end-diastolic, 28 and 14 mm Hg; wedge, 29 and 13 mm Hg; and left ventricular end-diastolic, 27 and 14 mm Hg.^Complete epicardiectomy and pericardiectomy was attempted in both patients.^However, hospital mortality was 100%; patient 1 died of multiorgan failure after six days, and patient 2 died of biventricular failure after 3 months.^A review of the literature revealed 44 cases of pericardiectomy for postirradiation constrictive pericarditis and a late survival rate of less than 50%.^The poor results in these patients compared with patients having pericardiectomy for other reasons seem to be due mainly to the various kinds of radiation-induced damage to the heart as a whole, including untimely coronary artery disease, myocardial fibrosis, atrioventricular conduction disturbances, and valve dysfunction, with the result that complete relief by epicardiectomy and pericardiectomy may not be technically feasible.^13 references.
Country of PublicationUnited States
LanguageEnglish
FormatPages: 445-448
System Entry Date2001 May 13

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