"Healing the Heart: A Retrospective Analysis of Surgical Management of Chronic Constrictive Pericarditis at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

Abstract Background: Chronic Constrictive pericarditis is a condition that can lead to diastolic heart failure due to a thickened, scarred, and non-compliant pericardium. Surgical intervention in the form of Pericardiectomy is the mainstay of treatment. Objectives: This retrospective study aims to describe the clinical characteristics, surgical management, and outcomes of patients with Chronic constrictive pericarditis treated with Pericardiectomy at Tikur Anbessa Hospital. Methods: Medical records of 49 patients who underwent Pericardiectomy for constrictive pericarditis at Tikur Anbessa Hospital from January 2012 to December 2016 were analyzed retrospectively. Data was collected using a well-structured questionnaire and analyzed using SPSS 20. Results: Of the 49 patients, 34 were male (69.4%) and 15 were female (30.6%) with a mean age of 25.06 +/- 13.884 (range 6-80 years). The most common presenting symptoms were shortness of breath (98%), leg swelling (75.5%), abdominal swelling (65.3%), and cough (44.9%). 73.5% of the patients had a medical history of tuberculosis. Median sternotomy was performed in all patients, with 71.4% undergoing total Pericardiectomy and 28.6% undergoing partial Pericardiectomy. The most common intraoperative and immediate post-operative complications were low output syndrome (8.2%), myocardial perforation (6.1%), bleeding (6.1%), and wound infections (4.1%). Mortality within the same admission or within 30 days post-operative was 2%. Conclusion: Pericardiectomy is an effective treatment for Chronic constrictive pericarditis and associated with excellent functional outcomes. Early diagnosis and surgical intervention are crucial in reducing morbidity and mortality. Tuberculosis remains an important cause of constrictive pericarditis in our setting.