Introduction
Many heart diseases affect the heart health and if left untreated may lead to complications. One of the heart conditions that occurs when the protective sac around the heart called pericardium becomes thickened or inflamed, it may restrict the heart’s ability to function properly. In severe cases, surgery called a pericardiectomy may be needed to remove part or all of the pericardium and relieve pressure on the heart.
This comprehensive post explores everything you need to know about pericardiectomy surgery, including its indications, procedure, benefits, risks, and recovery time.
Understanding Pericardiectomy Surgery
A pericardiectomy is a surgical procedure performed to remove part or all of the pericardium, which is a protective sac surrounding the heart. It is typically done under general anaesthesia and may take several hours depending on the complexity of the case and the patient’s condition.
The pericardium is composed of two thin layers separated by fluid, which helps reduce friction. as the heart beats. However, when the pericardium becomes repeatedly inflamed, it may thicken and stiffen over time.
This rigidity prevents the heart from expanding properly during each beat, impairing its ability to fill with blood. It may lead to increased pressure in the heart, a condition called constrictive pericarditis.
Why Is Pericardiectomy Done?
A pericardiectomy may be required in conditions, including
- Advanced cases of constrictive pericarditis
- Recurrent pericarditis or effusion when fluid buildup returns repeatedly
- A condition called cardiac tamponade, which is a collection of fluid that presses on the heart
- Autoimmune diseases or cancer affecting the pericardium
- Infections that cause thickening of the pericardium
- Complications from long-term anti-inflammatory medications given for less severe pericardium constriction.
When the pericardium no longer allows the heart to function properly, it may require surgery to make it effective.
What Happens During A Pericardiectomy?
Pericardiectomy is a surgery done under anaesthesia in a hospital testing.
- Pre-surgery examination: Your healthcare professional may perform different tests, including blood tests, chest x-ray, ECG, echocardiogram, CT scan, and MRI scan, before the procedure to understand the condition of the person and the relevant surgery undergone.
- Make an incision: The surgeon gives general anaesthesia before the surgery starts. The surgeon makes an incision over the breastbone to access the heart.
- Removal of inflamed pericardium: The surgeon removes a large part or the entire pericardium.
- Closure: The muscle and skin incisions will be closed, and a bandage will be applied.
The procedure usually takes two to three hours or more depending on the complexity of the procedure. While most pericardiectomies are open-heart surgeries, minimally invasive methods may also be used in selected cases.
Recovery After Pericardiectomy
Most patients stay in the hospital for five to seven days after the pericardiectomy. The healthcare professional will prescribe painkillers and other medications as required.
The patients may take six to eight weeks to fully recover, depending on the type of surgery and complications involved. Regular follow-up appointments and adherence to medications may be required.
It is recommended to avoid heavy lifting and vigorous exercise until cleared by your surgeon. Participation in cardiac rehabilitation is highly recommended to improve strength and monitor recovery.
Advantages Of Pericardiectomy
A pericardiectomy offers different advantages, including
- Relieves cardiac constriction, restoring normal heart function
- Provides relief from symptoms, including fatigue, swelling, and breathlessness
- Offers a cure for constrictive pericarditis
- Improves quality of life and exercise capacity in most patients.
Risks And Complications Of Pericardiectomy
The risks and complications of pericardiectomy include,
- Abnormal heart rhythms
- Blood clot or bleeding complications that may lead to stroke or other problems
- Complications from anaesthesia
- Fluid buildup around the lungs
- Injury to the phrenic nerve, which helps with breathing
- Pneumonia
- Infection
- Heart attack
- Low cardiac output syndrome
- Death in extreme cases.
If you observe any unusual symptoms after the surgery, it is recommended to seek immediate medical care to prevent further complications.
Conclusion
Pericardiectomy is a complex surgery done for individuals with severe or recurrent pericardial disease. It provides significant benefits, including relief from debilitating symptoms. Understanding the causes of pericardiectomy, what to expect during and after the surgery, and the path to recovery helps patients make informed decisions about the procedure.
If you or your loved one is experiencing any issues with heart, feel free to book a consultation with Dr Nikhil of Heart360 Care for personalized diagnosis and treatment regime.
Frequently Asked Questions
When the pericardium becomes stiff and inflamed as in constrictive pericarditis or recurring effusions, it prevents proper heart filling and causes systemic symptoms. A pericardiectomy is done to remove the pericardium to restore normal heart function.
Yes, most pericardiectomy is usually open-heart surgery which involves opening the chest to allow the surgeon to access the heart and remove the entire pericardium. In a few cases, a minimally invasive approach is done, which limits the amount of pericardium that can be removed, and open-heart surgery allows better access to the pericardium.
Yes, it is possible to live a long and normal life with successful pericardiectomy, especially when performed by experienced surgeons and with cardiac rehabilitation. It depends on several factors, including the cause of the constrictive pericarditis, age, other health problems, and type of surgery. According to studies, the survival rate at 5 and 10 years after pericardiectomy is about 87% and 78%.
A pericardiectomy is not painful during the procedure as it is performed under general anaesthesia. However, some pain post-surgery is common due to the chest incision and tissue healing. It is usually well-managed with medications, and most patients show improvement in symptoms within days to weeks after surgery.
