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Constrictive pericarditis developed after childhood repair of ventricular septal defect

Hirofumi Saiki1, Satoshi Masutani, Masanori Tamura

  • 1Department of Pediatrics and Pediatric Cardiology, Saitama Medical University, Saitama, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|August 6, 2013
PubMed

Insights

Constrictive pericarditis can be a serious delayed complication after congenital heart surgery. Echocardiography is crucial for diagnosing this condition and guiding treatment for improved heart failure outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • A patient with a history of surgical closure of ventricular septal defect (VSD) presented with syncope.
  • The patient experienced a long-term uneventful postoperative course before hospitalization.

Observation:

  • Diagnosis of atrial flutter and echocardiographic findings of poor ventricular motion and dilated atria.
  • Despite atrial flutter termination, persistent heart failure symptoms and limited improvement were noted.
  • Computed tomography revealed localized calcification, insufficient to explain severe diastolic dysfunction.

Findings:

  • Mitral annular tissue Doppler imaging waveform strongly suggested constrictive pericarditis.
  • Pericardial decortication led to significant improvement in heart failure symptoms.

Implications:

  • Constrictive pericarditis is a potential life-threatening complication years after congenital heart surgery.
  • Functional assessment using echocardiography is vital for establishing the relationship between imaging findings and clinical presentation.
  • Early and accurate diagnosis of constrictive pericarditis is essential for effective management in post-VSD repair patients.

Keywords:
adult congenital heart diseaseatrial flutterconstrictive pericarditispostoperative complicationventricular septal defect

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