Abstract

In tropical Africa, constructive chronic pericarditis are essentially from tuberulous origin. If the diagnosis of this affection has neatly improved during these last years, because of our sanitary units acquiring soecialised explorations, the surgical treatment always leads to difficulties, related to material conditions. The goal of this study is to present the experience of the Thoracic Vascular and Visceral unit of the Fondation Jeanna Ebori, upon 18 cases operated from 1986 to 1999. It is a retrospective study. The patients were 14 males and 4 females, mean age 36 years old. Clinical signs were dominates by dyspnca, found in 11 patients (61.1%). 5 patients were in fonctionnal grade III, and 4 in grade IV. according to NYHA classification. 3patients presented signs of acute heart failure, 16 had a cardiomegaly. Tuberculous origin had been demonstrated in 7 cases, and HIV was found in 2 cases. All patients had the benefit of a medical treatment before their admittance in surgery. This treatment was based on administration of antituberculous and corticotherapy. The surgical treatment was motivated by the gravity of heart fonctionnal status, or resistance to medical therapy. 17 patients therefore had the benefit of a partial pericardiectomy, performed by left anterior thoractomy, 4 patients died post operatively, and 5 were lost in vue after getting out of the hospital. 1 patient died 5 years later, and 4 were lost in vue. 4 patients are under medial control unit now, and their clinical status is quite satisfying. Surgical treatment of constructive chronic pericarditis presents some particularities in our practise, according to his indications, technical procedures, and the results obtained; all of them are related to the material conditions of our units, and the patients' socio-economical conditions.