Chronic Constrictive Pericarditis

Interventions on the pericardium are to be included among the first intrathoracic operations. They have greatly benefited from the advances made by modern intrathoracic surgery. Anesthesia is not effected any more by local infiltration of the walls, but by intratracheal general narcosis. The former horseshoe shaped incision, resecting 3–4 ribs, is now rectilinear and intercostal: the deformation of the thorax is considerably reduced. Decortication is effected on the two-thirds of the heart circumference, and only of the ventricles. As inner pleuro-pericardic drainage is made; effusions are aspired by pleural puncture. The results although satisfactory, are not always immediate.