[A case of chronic constrictive pericarditis with rheumatic valvular heart disease successfully treated by surgery]

Chronic constrictive pericarditis and rheumatic valvular heart disease are common surgical conditions, but the simultaneous occurrence of both is extremely rare and poses problems in diagnosis and treatment. A 47-year-old male with constrictive pericarditis and rheumatic valvular heart disease was successfully treated with operation. The valvular dysfunction had included aortic, mitral and tricuspid regurgitations. He had also complicated severe hepatic dysfunction due to the cardiac constriction and the secondary tricuspid valve regurgitation. With the aid of cardiopulmonary bypass radical pericardiectomy was performed for almost all cardiac surfaces including that of both ventricles, the right atrium, and the venae cavae. After the pericardiectomy, aortic valvular replacement, mitral and tricuspid valvular annuloplasties were performed. Postoperative course was uneventful and the hemodynamic abnormalities (elevated right atrial and ventricular end diastolic pressures) as well as the depressed hepatic functions were dramatically improved postoperatively.