Management

Pericardiectomy is the only definitive treatment for chronic constrictive pericarditis, and surgeons should attempt to remove as much of the pericardium as possible. Extensive penetration of the myocardium by fibrosis and calcification is associated with poor outcomes. Perioperative mortality ranges from 10% to 55% and has decreased over time. (1)

Diuretics can be used to reduce oedema or elevated venous pressures before the surgical procedure or for palliative control of symptoms in patients who are not surgical candidates. (2)

Reference

1. Khraishah H, Kwun A, Dearani JA, Alfaddagh A. Constrictive Pericarditis: A Comprehensive Overview. Heart Views. 2025 Jul-Sep;26(3):188-197
2. Liu VC et al. Pericardiectomy for Constrictive Pericarditis: Analysis of Outcomes. J Cardiothorac Vasc Anesth. 2021 Dec;35(12):3797-3805