Chronic Constrictive Pericarditis in a low-income-setting: Challenges and Outcome of Surgery

Abstract

Background: In a low-income setting like ours, chronic constrictive pericarditis is not uncommon. Affected patients present late for surgical management owing to poverty and ignorance. These two factors adversely affect the outcome of surgery.
Objective: To review 45 cases of chronic constrictive pericarditis done in our center with a view to determining the challenges and outcome of surgery.
Patients and Methods: This is a retrospective study spanning 10 years, 2011 to 2020. Data comprising of biodata, morphologic and histologic types including challenges and outcome of surgery were obtained from our hospital Record Department. Data were analyzed using SPSS version 22(Chicago) and results presented using bar chart, tables and pie chart.
Results: There were 45 patients. Of this number, there were 33 males (73.3%) and 12 females (27.7%). Age ranges affected were from 11-20 to 61-70 years. Morphologic types were totally calcific chronic constrictive pericarditis (4.4%), effusive chronic constrictive pericarditis (40%) and isolated chronic constrictive pericarditis (55.6%). Histologically, tuberculosis (60.0%) was most common, followed by idiopathic (33.3%). 2 patients were treated using cardiopulmonary bypass while the remainder had off-pump pericardiectomy, ranging from partial, total and radical. The outcome was poor in 30%, because they were not able to progress beyond NYHA class III despite ionotropic support and repeated paracentesis abdominis.
Conclusion: Chronic constrictive pericarditis especially when it presents late is a major cause of morbidity and mortality in the young population. Poorly equipped ICU and lack of highly trained personnels also affect adversely those who present for treatment.