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[Constrictive pericarditis after minimally invasive coronary artery bypass grafting: report of a case]

I Kigawa1, S Miura, S Fukuda

  • 1Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 17, 2009
PubMed

Insights

Constrictive pericarditis (CP) is a rare complication following minimally invasive direct coronary artery bypass (MIDCAB) surgery. This case report details successful surgical treatment for CP in a patient experiencing heart failure symptoms years after MIDCAB.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Pathology

Background:

  • Constrictive pericarditis (CP) is infrequently reported after off-pump coronary artery bypass grafting, particularly the minimally invasive direct coronary artery bypass (MIDCAB) approach.
  • CP can manifest years after cardiac surgery, presenting diagnostic challenges.

Observation:

  • A 57-year-old male developed exertional dyspnea four years post-MIDCAB.
  • Diagnostic imaging revealed significant pericardial thickening, and cardiac catheterization showed characteristic hemodynamic changes of constrictive physiology.

Findings:

  • The patient underwent successful pericardiectomy via median sternotomy with cardiopulmonary bypass.
  • Surgical intervention resolved the constrictive pericarditis, leading to improved hemodynamics and resolution of heart failure symptoms.

Implications:

  • This case highlights the possibility of late-onset constrictive pericarditis following MIDCAB.
  • Surgical pericardiectomy is an effective treatment for this rare complication, restoring normal cardiac function and patient quality of life.

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