Constrictive Pericarditis Following Correction of Partial Anomalous Pulmonary Venous Drainage

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Imaging

Background:

• Congenital heart defects often require surgical repair in infancy.
• Pulmonary valve replacement and repair of partial anomalous pulmonary venous connection are complex procedures.
• Tetralogy of Fallot repair is a common congenital heart surgery.

Observation:

• A 23-year-old man presented with right heart failure four months post-pulmonary valve replacement and partial anomalous pulmonary venous connection repair.
• Previous surgery included tetralogy of Fallot repair in infancy.
• Medical management for heart failure was unsuccessful.

Findings:

• Magnetic resonance imaging revealed a thickened pericardium, indicative of constrictive pericarditis.
• Radical pericardiectomy was performed.
• The patient experienced a good outcome following the pericardiectomy.

Implications:

• Constrictive pericarditis is a potential, though less recognized, cause of cardiac failure after congenital cardiac surgery.
• This condition can be misattributed to surgical failure or residual complications.
• Prompt diagnosis and surgical intervention, such as pericardiectomy, are crucial for managing this complication.