Remarkable advances have occurred in the understanding of the pathophysiology of pericardial diseases and the role of multimodality imaging in this field. Medical therapy and surgical options for pericardial diseases have also evolved substantially. Pericardiectomy is indicated for chronic or irreversible constrictive pericarditis, refractory recurrent pericarditis despite optimal medical therapy, or partial agenesis of the pericardium with a complication (eg, herniation). A multidisciplinary evaluation before pericardiectomy is essential for optimal patient outcomes. Overall, given the good outcomes reported, radical pericardiectomy on cardiopulmonary bypass, if feasible, is the preferred approach. Due to patient complexity, as well as the technical aspects of the surgery, pericardiectomy should be performed at high-volume centers that have the required expertise. The current review highlights the essential features of this multidisciplinary approach from diagnosis to recovery in patients undergoing pericardiectomy.

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心包疾病和心包切除术的最佳实践：JACC 最先进的评论


对心包疾病病理生理学以及多模态成像在该领域的作用的理解取得了显着进展。心包疾病的药物治疗和手术选择也有了很大的发展。心包切除术适用于慢性或不可逆缩窄性心包炎、尽管采用最佳药物治疗但难治性复发性心包炎或伴有并发症（例如疝气）的部分心包发育不全。心包切除术前的多学科评估对于获得最佳患者预后至关重要。总体而言，鉴于所报告的良好结果，如果可行，体外循环根治性心包切除术是首选方法。由于患者的复杂性以及手术的技术方面，心包切除术应在具有所需专业知识的大容量中心进行。当前的综述强调了这种多学科方法从心包切除术患者的诊断到康复的基本特征。