Péricardite chronique constrictive expérience du service de chirurgie cardio-vasculaire (A) (A propos de 43 cas)

Objectives:To report our experience in the diagnosis and management of the CCP does not load and compare our results with those of literature.
Introduction: Chronic constrictive pericarditis is a rare condition characterized by clinical signs of right heart failure, a consequence of the symphysis of the two pericardial layers. The etiology is the main cause tuberculosis in countries of the south, while north is the aetiology after cardiac surgery. Doppler echocardiography with CT or MRI, cardiac catheterization and especially facilitated the diagnosis. Medical treatment is limited; the pericardiectomy remains the only definitive treatment of the disease, with good results. Material and Methods:This study examined a retrospective analysis of 43 cases of patients undergoing PCC collected over a period of 11 years (2003-2013). The clinical characteristics, data from different investigations, the indications, means and methods of treatment and treatment outcomes were analyzed. Results:The average patient age was 32 years, 65% were men.Exertional dyspnea (95, 3%) was the most common sign. The peripheral signs were dominated by the turgidity of the jugular veins (76, 7%) and hepatomegaly (74, 7%). On examination the cardiac tachycardia (25, 5%) and the muffling of heart sounds (32, 5%).Radiography has objectified cardiomegaly (81, 3%) and pericardial calcification in 46, 5% of cases. Pericardial thickening (55, 8%) and signs of adiastoly in doppler and cardiac catheterization. Two major causes were found: tuberculosis 58% and 42% idiopathic. Allpatients underwentsubtotalpericardiectomythroughmediansternotomywith95.3%without CPB. The postoperative course was uneventful in 55, 8% of patients. Theperioperative mortalitywas encounteredin two patients (4.6%). Conclusion:The PCC, although rare should be raised before signs of right heart failure associated with signs of hemodynamic adiastoly. The cause tuberculosis is still common in our skies. Remains the essential treatment pericardiectomy with good results in the medium and long term

Lien document
AuteurDriouech H
DisciplineCentre Hospitalier Universitaire Ibn Sina - Rabat
EncadrantLaaroussi M