[Re-operation for Recurrent Constrictive Pericarditis with Multiple Organ Dysfunction]

The patient was a 64-year-old man with recurrent constrictive pericarditis which developed 12 years after the initial pericardiectomy. He had bilateral heart failure with severe left ventricular diastolic dysfunction, massive ascites, renal failure, and coagulopathy. Computed tomography showed a heavily calcified pericardium around the right atrium, the phrenic side of the right ventricle, and the left ventricle. He underwent pericardiectomy via median sternal re-entry. The calcified pericardium was safely decorticated with an ultrasonic surgical knife. The pericardium around the left ventricular side was safely decorticated under cardiopulmonary bypass and use of a heart positioner. Although permanent hemodialysis was necessary after the operation, he has been well for 6 years since the operation.