Related Experiment Video
Updated: Jun 15, 2026
05:31
Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Localized constrictive pericarditis after Gore-Tex pericardial substitution.
Eric Bergoënd1, Michel Marchand, Danielle Casset-Senon
1Department of Cardiac Surgery, Centre Hospitalier Universitaire, University François-Rabelais, Tours, France. ebergoend@hotmail.com
Interactive Cardiovascular and Thoracic Surgery
|February 25, 2010
Summary
Delayed constrictive pericarditis can occur years after expanded polytetrafluoroethylene (ePTFE) membrane pericardial substitution, particularly when the membrane covers both anterior and diaphragmatic aspects of the heart. Surgical release of epicardial adhesions significantly improved patient outcomes and cardiac function.
Area of Science:
- Cardiovascular Surgery
- Cardiac Imaging
- Pericardial Disease
Background:
- A 65-year-old patient with a history of aortic prosthesis replacement and expanded polytetrafluoroethylene (ePTFE) membrane pericardial substitution presented with recurrent cardiac decompensation.
- Diagnosis of constrictive pericarditis was challenging, with radionuclide ventriculography being the most informative imaging modality.
Observation:
- Surgical re-exploration revealed an epicardial fibrous band restricting right ventricle diastolic expansion.
- This band was located between the anterior free wall and the diaphragmatic portion of the right ventricle.
Findings:
- Surgical excision of the epicardial fibrous band led to dramatic clinical improvement.
- Post-operative radionuclide imaging demonstrated improved ventricular filling curves.
Implications:
- This case highlights the potential for delayed constrictive pericarditis following ePTFE pericardial substitution.
- Careful consideration of membrane placement, avoiding coverage of both anterior and diaphragmatic surfaces, may mitigate this risk.
Related Concept Videos
01:17Pericarditis III: Medical Management
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
01:22Pericarditis I: Introduction
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
01:19Pericarditis II: Clinical Features and Diagnostic Tests
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:21Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
01:25Pericarditis IV: Nursing Management
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.