Pericardiectomy for radiation-induced constrictive pericarditis

Abstract

Introduction: Of oncological patients who have undergone chest radiation therapy, 20% develop radiation-induced constrictive pericarditis. The purpose of this study was to review our clinic's experience of such cases, focusing on survival and the functional outcome.

Methods: Six patients with a history of previous radiation therapy, aged 33-61 years, most of whom had symptoms of heart failure, underwent radical (2 patients) or partial (4 patients) pericardiectomy.

Results: All patients were completely free of cardiovascular events during the 8 years covered by the study. Among the postoperative complications the most serious was low cardiac output syndrome in 4 patients, which was treated successfully.

Conclusions: Radiation-induced constrictive pericarditis is a clinical entity that should be taken into account in the differential diagnosis of oncological patients who show signs of heart failure. Surgery is the only effective treatment. The results are satisfactory, but always depend on associated damage to the myocardium as a result of radiation and on the underlying cancer.