Pericardiectomy for constrictive pericarditis.

Pericardiectomy is well recognized as a logical and rewarding form of treatment for constrictive pericarditis. The historical background of the operation has been fully described by Sellors (1946) and it is not felt that the series of cases to be presented here has anything to add to the clinical picture of constrictive pericarditis so fully described by Evans and Jackson (1952). There are certain aspects on the surgical management of constrictive pericarditis, however, on which opinions still vary. Which region of the heart is it particularly important to liberate when performing pericardiectomy ? Is it necessary or justifiable to attempt the complete excision of the pericardium? Is an incomplete removal of the pericardium compatible with a good functional result? What is the least traumatic exposure consistent with adequate pericardiectomy ? These are questions which are still debated and it is the aim of this article to try to answer them.