[Development of constrictive pericarditis 20 years after closed mitral commissurotomy--a case report]

Pericardial constriction has emerged as an infrequent but well documented late complication of cardiac surgery. A rare case of constrictive pericarditis developed 20 years after closed mitral commissurotomy was observed. The patient had been treated for the poorly controlled ascites of unknown origin associated with crural edema and mild congestive liver cirrhosis. The long interval between the previous cardiac operation and the clinical manifestation of constriction made it difficult to establish the diagnosis. Extensive resection of the calcified pericardium through a median sternotomy with cardiopulmonary bypass standby relieved the ascites and crural edema.