Este protocolo se aplica a pacientes con constricción pericárdica en ausencia de pericarditis activa, incluidos aquellos con constricción crónica establecida y aquellos cuya condición no ha respondido al tratamiento médico. Estos pacientes representan un grupo clínico diferenciado que requiere un manejo oportuno y definitivo.
En este contexto, la intervención quirúrgica dirigida al pericardio es el enfoque primario establecido. Cuando también está presente patología valvular significativa, puede estar indicada la cirugía valvular concomitante.
Cases after failure of medical therapy and pericardial constriction without pericarditis should be referred for pericardiectomy without delay.
Pericardiectomy is the mainstay treatment for chronic constriction or CP not responding to anti-inflammatory therapy.
Complete pericardiectomy is recommended for the management of CP, as it offers superior long-term outcomes and significantly reduces the risk of recurrences compared with partial anterior or anterophrenic pericardiectomy, which may leave residual constrictive tissue and contribute to persistent or recurrent symptoms.
Surgical pericardiectomy is recommended in patients with chronic pericardial constriction or persistent constrictive pericarditis despite medical therapy to improve symptoms and survival.
Tricuspid valve repair is recommended in patients with pericardial constriction and severe tricuspid valve regurgitation to improve symptoms and survival.
View source ↗