In a pericardiectomy, the heart surgeon removes the membrane that surrounds the heart, which is called the pericardium. This keeps fluid from continuing to accumulate in the area between the heart and pericardium, which can squeeze the heart and cause it not to work properly. Heart surgeons at the Ohio State Wexner Medical Center in Columbus have tremendous experience performing pericardiectomies.
Conditions treated
Cardiologists most commonly use this procedure to treat a condition called constrictive pericarditis or to remove a pericardium that’s hard and fibrous.
What is pericarditis?
The pericardial sac that surrounds the heart has two layers. Normally, this sac contains lubricating fluid. When the sac is inflamed (swollen), the two layers will rub against each other, causing chest pain.
The condition may clear up fairly quickly without treatment, or it can last weeks or even months. The chest pain can range from dull to stabbing, and it can also affect the neck and left shoulder. Some people have difficulty telling if the chest pain they’re feeling is due to pericarditis or a heart attack. Because of this, it’s important that you receive a speedy, accurate diagnosis of your condition.
Pericarditis causes
Most often, physicians can’t determine the cause of pericarditis. In some cases, a viral infection may be causing the pericarditis. Other causes include:
- Certain medications
- Conditions such as autoimmune deficiency syndrome (AIDS), cancer, tuberculosis or kidney failure
- Inflammatory conditions such as rheumatoid arthritis or lupus
- Traumatic chest or heart injury
Some people develop pericarditis after a heart attack or heart surgery. This type of pericarditis is called Dressler’s syndrome.
Pericarditis symptoms
Symptoms can include:
- Chest pain
- Difficulty catching your breath when lying down
- A low fever and fatigue
Pericarditis can result in damage to the pericardium, causing rigidity that prevents the heart from proper function. This type of pericarditis is called constrictive pericarditis.
Pericarditis diagnosis
Using a stethoscope, a physician may be able to hear the layers of the pericardium rubbing together. They may also order tests to check for a heart attack and infection. The primary diagnostic tests for pericarditis include:
Pericarditis treatment
Medication
Physicians may prescribe medication to reduce pain and inflammation from pericarditis. If a bacterial infection caused the pericarditis, your doctor will likely prescribe antibiotic medication.
If antibiotics don’t relieve your symptoms, you may need treatment with corticosteroids and a medication called colchicine.
Pericarditis typically lasts for a few weeks. Recurring cases are possible.
Surgery and other procedures
Cardiac tamponade is a serious complication of pericarditis, and it’s treated with a pericardiocentesis. In this procedure, a cardiologist inserts a needle or small tube (catheter) to remove excess fluid from the pericardium. This procedure is just one of the interventional cardiology procedures we offer.
Constrictive pericarditis is another dangerous complication of pericarditis. In this situation, cardiac surgeons may need to perform a pericardiectomy to remove rigid areas of the pericardium.
What to expect during a pericardiectomy
Preparing for a pericardiectomy
Prior to your pericardiectomy, you’ll meet with your doctor to discuss your medical history, the medicines you take and any questions you have about the procedure.
During a pericardiectomy
The anesthesiologist will give you general anesthesia prior to your surgery, which means you’ll be fully asleep for the procedure. Your surgeon makes an incision over the breastbone then spreads the ribs to allow access to the heart. When the surgeon reaches the heart, they strip off and remove the pericardium (membrane around the heart). The surgeon then wires the breastbone back together and closes the incision.
After a pericardiectomy
After surgery, members of your surgical team take you to the postoperative recovery area for close monitoring. You’ll receive pain medication as needed. It’s important to keep the incision areas clean and dry.
The length of your hospital stay depends on how quickly you’re able to recover and perform some physical activity. If you experience fever, and/or severe pain, redness, swelling or warmth where the incisions were made or drainage from the incisions, inform your doctor immediately. Your surgeon will give you specific instructions about recovery at home.