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Answer to your Health Question

Question:

Please advise on what caution needs to be taken after a Pericardiectomy and why.

Any other useful information will be appreciated to.

Thank you your assistance is appreciated

Answer:

It is important to keep the incision areas clean and dry.

Symptomatic relief and normalization of cardiac pressures may take several months after pericardiectomy.

Longer-term mortality rates after pericardiectomy exceed those of age-matched populations.

The majority of patients demonstrate a symptomatic improvement after surgery, but up to 25% remain symptomatic.

Persisting heart failure symptoms may necessitate continued diuretic therapy. Left ventricular systolic dysfunction may occur after pericardial stripping mainly due to myocardial fibrosis; this should be treated with ACE inhibitor and beta-blocker therapy in the usual fashion.

Survival after pericardiectomy is greatly dependent on patient age.

A review of the few reports in literature about repeat operations for recurrent pericardial constriction, reveals that all of the reported cases were as a result of partial pericardiectomy with residual pericardium in the posterior surface of the heart.

Diastolic filling characteristics remain abnormal in a substantial number of patients with constrictive pericarditis after pericardiectomy. These abnormalities may resolve gradually but can persist.

Diastolic filling abnormalities after pericardiectomy correlate well with clinical symptoms and tend to occur in patients who have had symptoms longer preoperatively.

Complete pericardiectomy using a right anterolateral thoracotomy can be performed safely and can lead to long-term survival and good functional results.

Long-term survival after pericardiectomy for constrictive pericarditis differs significantly based on disease etiology.

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