What is a pericardiectomy?

A pericardiectomy, also called pericardial stripping, is the surgical removal of the pericardium — the fibrous sac that surrounds the heart and protects it from infection and other diseases. The pericardium contains fluid that helps lubricate the heart during pumping movements.

Who is a candidate for a pericardiectomy?

Patients who have chronic constrictive pericarditis or recurrent pericarditis who have not experienced relief with medical management may be candidates for a pericardiectomy. 

Constrictive pericarditis is a condition where the pericardium is stiff or calcified. The condition can be caused by previous heart surgery, radiation to the chest, cancer, tuberculosis, mesothelioma, infections or surgical complications.

Recurrent pericarditis is a condition that occurs when pericarditis symptoms recur even after the agent that caused the original condition is eliminated.

In patients with constrictive pericarditis, the heart may not be able to stretch as it normally does when it beats in healthy patients. When this occurs, blood can back up behind the heart and cause swelling and symptoms of heart failure.

What to expect during a pericardiectomy

A pericardiectomy is a procedure that must be performed through open heart surgery. Your cardiothoracic surgeon will perform a sternotomy (incision through the breastbone) so that he or she can reach the heart. 

Your Mercy Health cardiothoracic surgeon will then remove a portion of the entire pericardium from the heart. Once the procedure is complete, the surgeon will connect the breastbone and ribs back together and close the incision.

Risks of a pericardiectomy

Because a pericardiectomy is a major cardiac surgery, it is important to understand the complications associated with the procedure.

Complications include:

  • Cardiac arrhythmias
  • Blood clots
  • Severe bleeding that leads to the need for a blood transfusion
  • Heart attack
  • Infection
  • Pneumonia 
  • Fluid buildup around the lungs 

Women, elderly patients and patients who have chronic medical problems are more likely to suffer from complications associated with a pericardiectomy.

Recovery from pericardiectomy

Recovery from a pericardiectomy is a long process. Most patients stay in the hospital up to seven days. After discharge, you can slowly return to your normal activities. You will not be able to lift heavy objects until you are fully cleared by your doctor. It typically takes six to eight weeks to recover from a pericardiectomy. Patients with severe pericarditis may need more than eight weeks to fully recover.

Your doctor will recommend regular follow-ups after a pericardiectomy starting at six weeks post-surgery. An echocardiogram can show how well the heart is pumping. If the heart is not functioning properly, your doctor will evaluate the best course of treatment for you.

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