Results
The study included a total of 100 adult patients with a history of prior mediastinal irradiation who underwent pericardiectomy for constriction (median (IQR) age 56.8 (50.9, 65.9) years, 49% females). Demographic characteristics are shown in Table 1. Hodgkin’s disease was the most common malignancy (64%) for which mediastinal radiation had been received, followed by breast cancer (15%). Most of the patients (75%) had New York Heart Association (NYHA) class III/IV symptoms at presentation. Pericardiectomy was the first cardiovascular surgical procedure in 66% of patients. The median (IQR) duration between mediastinal irradiation and surgery was 28.5 (20, 34) years.
The operative characteristics are outlined in Table 2. The surgical approach was by a full midline sternotomy in 95% of patients, and cardio-pulmonary bypass was used in 96%. Only 27% of patients had an isolated pericardiectomy. A radical resection was performed in 50% of patients, whereas 47% underwent a subtotal resection.