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[Pericardiectomy of effusive constrictive pericarditis with an ultrasonic scalpel; report of a case]
Hideaki Kanda1, Yukinori Moriyama, Yoshihiro Fukumoto
1Department of Cardiovascular Surgery, Kagoshima Medical Center, Kagoshima, Japan.
Insights
Effusive constrictive pericarditis, a rare condition, can be treated with pericardiectomy. A novel technique using an ultrasonic scalpel without cardiopulmonary bypass proved successful in a recent case.
Area of Science:
- Cardiology
- Thoracic Surgery
Background:
- Effusive constrictive pericarditis is a rare condition combining pericardial effusion and constriction.
- Pericardiectomy is the primary treatment, but carries high perioperative risks.
Observation:
- A 45-year-old male patient presented with effusive constrictive pericarditis.
- The patient underwent a visceral pericardiectomy with a waffle procedure.
Findings:
- The procedure was successfully performed using an ultrasonic scalpel.
- Cardiopulmonary bypass was not required, minimizing surgical invasiveness.
- The patient experienced an uneventful recovery with normalized cardiac hemodynamics.
Implications:
- This minimally invasive approach offers a potentially safer alternative for treating effusive constrictive pericarditis.
- Successful outcomes suggest the ultrasonic scalpel technique is effective for visceral pericardiectomy.
- Long-term follow-up showed no recurrence, indicating sustained therapeutic benefit.
Abstract:
Effusive constrictive pericarditis is a rare clinical entity characterized by concurrent pericardial effusion and visceral pericardial constriction. The most effective therapy for this state is pericardiectomy with complete removal of the parietal and visceral membranes, although the perioperative mortality and morbidity can be high. We presented a case of a 45-year-old man in whom a visceral pericardiectomy with waffle procedure was successfully performed using an ultrasonic scalpel without use of cardiopulmonary bypass. His postoperative course was uneventful and cardiac hemodynamics restored to normal. There were no signs or symptoms of recurrence in 2 years of follow-up.
