# Unlocking the Heart: A 10-Year Experience of Interventions and Outcomes of Constrictive Pericarditis in a Northeast Indian Tertiary Care Center

## TL;DR

This study reviews 10 years of surgical outcomes for constrictive pericarditis in a Northeast Indian hospital, showing that early surgery improves survival.

## Contribution

A detailed 10-year retrospective analysis of pericardiectomy outcomes in a specific geographic region.

## Key findings

- Most patients had severe heart failure (NYHA class III/IV) at surgery.
- In-hospital mortality was 14.6%, primarily due to low cardiac output.
- Early surgical intervention is linked to better short-term survival.

## Abstract

Introduction: Chronic constrictive pericarditis (CCP) is a debilitating condition characterized by thickening and fibrosis of the pericardium, leading to impaired diastolic filling and reduced cardiac output. Patients typically present with symptoms of right-sided heart failure, such as peripheral edema, ascites, and dyspnea. Definitive treatment involves surgical pericardiectomy, which aims to remove the constrictive pericardium and restore normal cardiac function. This study aims to assess the operative and short-term outcome of this rare disease in the northeastern part of India.

Methods: Retrospective data records of patients who underwent pericardiectomy were analyzed from 2011 to 2020.

Results: Of the patients, 20 (47.6%) were in New York Heart Association (NYHA) class III, and 12 (28.6%) were in NYHA class IV. Hyperbilirubinemia was seen in 29 (69%) patients, and hypoalbuminemia in 18 (42.9%) patients. Radical pericardiectomy was done in 36 (85.7%) cases, and the waffle operation was done in five (12%) cases. The mean ICU stay post procedure was 5.81 days (2-18 days), and the mean hospital stay was 19.6 days (2-49 days). The in-hospital mortality rate was 14.6% (six cases), and the cause of death in all cases was persistent low cardiac output.

Conclusion: Pericardiectomy is the only definitive treatment for symptomatic CCP, and it gives a chance to the patient for a full recovery from the chronic morbidity and mortality it is associated with. The right time for surgical intervention is still not clear and needs to be individualized for each patient, but the earlier the intervention, the better the short-term survival.