[A rare cause of right cardiac insufficiency after pneumonectomy]

The authors report the case of a 55-year old patient, hospitalized for assessment of progressive right heart failure after left pneumonectomy due to bronchial epidermoid cancer. Right catheterization showed a dip-shaped right ventricular plateau and equal diastolic pressures (DOP 21 mmHg, diastolic pressure of the right ventricle 25 mmHg, capillary pressure 25 mmHg). A chest scan ruled out the possibility of pericardial invasion. Pericardial decortication was carried out on October 3, 1989. Six months later, the clinical signs of right heart failure had regressed. Chronic constrictive pericarditis (CCP) has been reported after cardiac surgery, but not cases have been reported after pulmonary surgery. In the absence of radiotherapy or metastatic invasion, this case leads to a discussion of the possibility of either pericardial trauma during surgery or, more probably, a fortuitous association with tubercular CCP.