Pediatric pericardiectomy-a narrative review - PubMed
12 hours ago
- #pediatric-surgery
- #pericarditis
- #cardiac-surgery
- Pediatric pericardiectomies are rare operations for recurrent, purulent, or constrictive pericarditis.
- Most common etiology in pediatric patients is idiopathic; prior cardiac surgery (US) and bacterial infections (India) follow.
- Main symptoms include dyspnea, chest pain, or heart failure (>80% of cases).
- Transthoracic echocardiogram (TTE) is the primary imaging test for diagnosis.
- Adult pericarditis guidelines can inform pediatric care, including timing for pericardiectomy.
- Pericardiectomy is the main treatment for chronic constrictive pericarditis; delays may cause irreversible damage.
- Most pediatric pericardiectomies (~90%) do not require cardiopulmonary bypass.
- Complete pericardiectomies and median sternotomy are the most common surgical approaches.
- Mortality rates: ~2% in the US vs. ~11% in lower-resourced countries (tubercular etiology or delayed presentation).
- Further research is needed on outcomes related to timing of pediatric pericardiectomies.