Skip to main content
  • Meeting abstract
  • Open access
  • Published:

Natural History of Echocardiographic and Hemodynamic Changes Following Isolated Pericardiectomy for Constrictive Pericarditis


Pericardiectomy has been shown to improve the functional status of patients with constrictive pericarditis and resultant heart failure symptoms. However, there are few studies following the chronic hemodynamic impact of surgery on the left ventricle, right ventricle and tricuspid valve.


We sought to identify a homogenous cohort of patients undergoing surgery for constrictive pericarditis. Echocardiographic data would be collected through the length of their followup, assessing for left ventricular function, right ventricular function and valvular dysfunction to help to better understand the long term outcomes of pericardiectomy.


January 1993 to December 2013, 938 patients underwent pericardiectomy at our institution. To establish a homogeneous population, we included patients with constrictive pericarditis and excluded patients with prior chest radiation and concomitant valvular or coronary procedures.


We identified a cohort of 355 patients. Median age at operation was 62 (range 18-84) and 282 (79%) were male. Median pre-operative NYHA Functional class was III and 300/356 (84%) patients were in class III/IV. All patients underwent isolated pericardiectomy; early mortality was 2.5%. During median follow-up of 29 months (max 20.5 yr), 507 echocardiograms were reviewed for tricuspid regurgitation (TR), right ventricular (RV) dysfunction, RV systolic pressure (RVSP), and left ventricular ejection fraction (LVEF). TR grade increased during follow-up from trivial to mild (p = 0.02). Despite this finding, there was no demonstrable impact on RV function or RVSP. Additionally, LVEF remained stable over follow-up. Median NYHA Functional class at last follow-up was I (77% class I/II).


Pericardiectomy is safe and provides significant improvement in functional status during late follow-up. A concern with surgery is the potential for ventricular dilation and dysfunction post-operatively. Our data demonstrate patients undergoing pericardiectomy for constriction have stable ventricular function in late follow-up. There is an observed increase in TR grade from trivial to mild, but we did not observe an associated functional or hemodynamic consequence.

Author information

Authors and Affiliations


Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit

The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gillaspie, E.A., Stulak, J.M., Daly, R.C. et al. Natural History of Echocardiographic and Hemodynamic Changes Following Isolated Pericardiectomy for Constrictive Pericarditis. J Cardiothorac Surg 10 (Suppl 1), A63 (2015).

Download citation

  • Published:

  • DOI: