[Surgical treatment of constrictive pericarditis and life-threatening pericardic effusions (author's transl)].

Total excision of both pericardic sac and epicardium is the basic surgical procedure for chronic constrictive pericarditis. Approach being through a vertical sternotomy. In case of either cardiac injury or poor haemodynamic of either cardiac injury or poor haemodynamic conditions, it is sometimes indicated to get help from an extracorporal circulation with femoro-femoral shunt. Surgery for acute pericarditis may vary according to local and general conditions. As soon as a pericardic effusion, whether or not infected, has occurred, drainage by means of an infraxiphoid incision seems to be a safe method. Where pericardic effusions relapse or densify to a constrictive pericarditis, pericardectomy is to be considered. Total pericardectomy is therefore regarded as the best procedure to prevent further disease.