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Recurrent cardiac constriction after complete pericardiectomy
Elsayed M Elmistekawy1, John P Veinot, Carole J Dennie
1Division of Cardiac Surgery, University of Ottawa Heart Institute, University of Ottawa, Canada.
Heart, Lung & Circulation
|June 7, 2011
Summary
Recurrent constrictive pericarditis after pericardiectomy is rare. Repeat surgery and steroids may manage this condition, offering hope for patients with persistent fibrotic constriction.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Research
Background:
- Constrictive pericarditis can significantly impair cardiac function.
- Complete pericardiectomy is a surgical option for refractory cases.
- Post-operative fibrosis can lead to recurrent constriction.
Observation:
- A patient developed recurrent constrictive physiology post-pericardiectomy.
- Extensive fibrotic and calcified rind necessitated a repeat stripping procedure.
- Non-tuberculous pericarditis was implicated in the recurrence.
Findings:
- Recurrence of constrictive physiology after complete pericardiectomy is uncommon.
- Repeat surgical intervention (stripping) was performed.
- Significant fibrotic and calcified adhesions were noted during re-operation.
Implications:
- This case highlights the possibility of recurrent constriction despite complete pericardiectomy.
- Repeat surgery may be a viable management option.
- Steroid administration warrants consideration in managing such cases.
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