Methods
We retrospectively reviewed 130 adult patients (age ≥ 18 years) who
underwent pericardiectomy with a prior history of mediastinal
irradiation, from June 2002 to June 2019 at the Mayo Clinic in
Rochester, Minnesota. Both primary and re-operative procedures were
included. The study was approved by the Institutional Review Board at
Mayo Clinic, Rochester, Minnesota (Date 2/8/2019, IRB no - 19-000542).
Individual patient consent requirement was waived as the study was
deemed a minimal-risk retrospective study; 2 patients without research
authorization were excluded. Patient characteristics were obtained from
the prospectively collected database based on definitions set forth by
the Society of Thoracic Surgeons (STS) Adult Cardiac Database with
additional review of patient records for supplementing missing
information.14
Patients who underwent pericardiectomy for an indication other than a
pre-operative diagnosis of constriction (N=28) were excluded, leaving
100 patients for study inclusion. Our surgical approach and operative
techniques for pericardiectomy have been previously
reported.7, 10, 15-17 A radical resection was defined
as removal of anterior, inferior (diaphragmatic) and lateral pericardium
posterior to the phrenic nerves. Any pericardial resection that did not
meet the criteria for radical resection was defined as subtotal
resection. Operative mortality was defined as any death, regardless of
cause, occurring within 30 days after surgery, or during the same
hospitalization as the index surgery, regardless of time.