Predictors for Peri-Operative and early thirty days mortality after Pericardiectomy for chronic Constrictive Pericarditis: A Retrospective study at IGIMS

Author(s): Tushar Kumar, Aandrei J Jha, Madhav Kumar

Background: Constrictive pericarditis (CP) is a rare condition characterized by pericardial rigidity, impairing cardiac filling and causing systemic congestion. Pericardiectomy is the definitive treatment but carries significant morbidity and mortality. Limited data exist on predictors of outcomes following surgery.

Methods: This retrospective study analyzed 53 patients with CP who underwent pericardiectomy at IGIMS, Patna, between December 2021 and October 2024. Clinical, laboratory, imaging, and intraoperative data were collected. Mortality predictors were evaluated using univariate, multivariate, and survival analyses.

Results: The study cohort (mean age: 59 years; 67.9% male) showed high prevalence of NYHA class III–IV symptoms, peripheral oedema (54.7%), and pericardial thickening (88.7%). Over 70% had preserved LV systolic function, but 67% had diastolic dysfunction. Complete pericardiectomy was performed in 54.7% of patients. The 30-day mortality was 18.9%, with significant postoperative complications including dialysis (30.2%) and reintubation (26.4%).

Conclusion: Constrictive pericarditis presents with apparently preserved LV function but complex haemodynamics and significant comorbidities. Surgical pericardiectomy, though effective, carries considerable perioperative risk.