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.