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Tuberculous constrictive pericarditis and atrial septal defect: Surgical challenge
Siddharth Lakhotia1, Mukesh Kumawat2, Sharad Kumar Mathur3
1Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences and Associated SS Hospital BHU, Varanasi, India drslakhotia@gmail.com.
Asian Cardiovascular & Thoracic Annals
|July 1, 2015
Summary
Tuberculous constrictive pericarditis with atrial septal defect is rare. Surgical repair complications led to readmission, requiring further intervention for patch dehiscence and right ventricular compression.
Area of Science:
- Cardiology
- Thoracic Surgery
- Infectious Diseases
Background:
- Tuberculous constrictive pericarditis is a rare condition.
- Atrial septal defects (ASDs) are congenital heart abnormalities.
- The simultaneous occurrence of these conditions presents unique surgical challenges.
Observation:
- A 23-year-old male patient with tuberculous constrictive pericarditis and an ASD underwent pericardiectomy and ASD closure.
- Cardiopulmonary bypass was established via aortic and right atrial cannulation due to difficulties with femoral access and visualization of the venae cavae.
- Postoperative recovery was initially satisfactory, but the patient was readmitted one month later with generalized swelling and exertional dyspnea.
Findings:
- Echocardiography revealed atrial septal defect patch dehiscence and a bidirectional shunt.
- A mass or collection was identified, compressing the right ventricle.
- Subxiphoid exploration was performed, leading to the resolution of the swelling.
Implications:
- This case highlights the complex management of rare combined cardiac conditions.
- It underscores the importance of vigilant postoperative monitoring for potential complications such as patch dehiscence.
- Successful surgical intervention, even when complex, can lead to favorable outcomes.
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