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Transient right ventricular dysfunction after pericardiectomy in patients with constrictive pericarditis
Hee Tae Yu1, Jong-Won Ha, Sak Lee
1Cardiology Division, Severence Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean Circulation Journal
|July 7, 2011
Summary
Pericardiectomy for constrictive pericarditis can cause transient right ventricular (RV) failure due to volume overload. Prompt treatment with diuretics and inotropics improved RV function in a case study, highlighting the need for monitoring RV dysfunction post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Physiology
Background:
- Pericardiectomy is the standard treatment for symptomatic chronic constrictive pericarditis.
- Post-pericardiectomy heart failure with volume overload, particularly affecting the right ventricle (RV), can occur due to myocardial atrophy and increased venous return.
- Right ventricular dysfunction is a recognized complication following pericardial decompression.
Purpose of the Study:
- To report a case of transient right ventricular failure after pericardiectomy for constrictive pericarditis.
- To emphasize the significance of volume overload and RV dysfunction in patients undergoing pericardiectomy.
- To highlight the importance of echocardiographic monitoring and appropriate medical management in the post-operative period.
Main Methods:
- A case report of a 44-year-old male patient who underwent pericardiectomy for constrictive pericarditis.
- Echocardiography was used to assess RV size, function, and tricuspid annular systolic velocity.
- Medical management included inotropics and diuretics for RV failure.
Main Results:
- The patient developed transient severe RV dysfunction, characterized by RV dilation and reduced tricuspid annular systolic velocity, immediately after pericardiectomy.
- Following treatment with inotropics and diuretics, follow-up echocardiography showed improved RV systolic function and decreased RV chamber size.
- The patient's condition resolved with medical management, indicating a transient nature of the RV failure.
Conclusions:
- Volume overload and subsequent right ventricular dysfunction are critical considerations in patients undergoing pericardiectomy for constrictive pericarditis.
- Early recognition and management of RV dysfunction with inotropics and diuretics can lead to favorable outcomes.
- This case underscores the necessity of vigilant echocardiographic surveillance for RV function post-pericardiectomy.
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