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Exacerbation of severe constrictive pericarditis after prior inadequate pericardiectomy

Yoshinori Kuroda1, Tetsuro Uchida1, Masahiro Mizumoto1

  • 1Division of Cardiovascular Surgery, Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan.

Cardiovascular Journal of Africa
|July 28, 2020
PubMed

Insights

Complete pericardiectomy is crucial for treating constrictive pericarditis (CP). Thorough removal of calcified pericardium improves surgical outcomes and prevents CP recurrence.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Constrictive pericarditis (CP) is often treated with pericardiectomy.
  • Persistent pericardial calcification can complicate surgical recovery and lead to recurrent CP.

Observation:

  • An 82-year-old male presented with recurrent CP after a prior inadequate pericardiectomy.
  • Pre-operative imaging revealed extensive calcification, forming a calcium envelope, particularly on the inferior aspect of the heart.
  • A paste-like substance was noted during dissection of the calcified pericardium.

Findings:

  • Pericardiectomy was performed via re-sternotomy without cardiopulmonary bypass.
  • The patient experienced improved cardiac function post-surgery.
  • Postoperative recovery was prolonged due to persistent heart failure symptoms.

Implications:

  • Maximal excision of calcified pericardium is essential for effective pericardiectomy.
  • Complete calcification removal enhances early surgical results and reduces the risk of constrictive pericarditis recurrence.
  • This approach may improve long-term outcomes for patients with complex constrictive pericarditis.

Keywords:
recurrent pericarditisconstrictive pericarditispericardiectomy

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