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Unmasking of severe mitral regurgitation after pericardiectomy

Pavan Kumar Dammalapati1, Sandeep Kumar Kar1, Subhendu Sekhar Mahapatra2

  • 1Department of Cardio Thoracic Vascular Anaesthesiology, Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, 700020 India.

Indian Journal of Thoracic and Cardiovascular Surgery
|June 22, 2023
PubMed

Insights

Mitral regurgitation (MR) can coexist with constrictive pericarditis (CP). Intraoperative transesophageal echocardiography (TEE) is crucial for diagnosing and managing these combined cardiac conditions.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Mitral valve prolapse is a primary cause of mitral regurgitation (MR) in young individuals.
  • Constrictive pericarditis (CP) represents an end-stage outcome of pericardial inflammation, leading to restricted cardiac filling and diastolic pressure equalization.
  • Coexistence of intracardiac valvular pathologies with CP is possible.

Observation:

  • This case report details a patient with effusive constrictive pericarditis (CP).
  • The patient also presented with co-existing mitral regurgitation (MR).

Findings:

  • Intraoperative transesophageal echocardiography (TEE) was instrumental in identifying both effusive CP and MR.
  • TEE facilitated accurate assessment of the co-existent valvular and pericardial lesions.

Implications:

  • Accurate diagnosis of co-existing MR and CP is vital for effective surgical planning.
  • Intraoperative TEE plays a pivotal role in guiding surgical decisions for complex cardiac cases involving pericardial and valvular disease.
  • This case underscores the importance of comprehensive echocardiographic evaluation in patients with suspected or confirmed CP.
Keywords:
Constrictive pericarditisMitral regurgitationTransesophageal echocardiography

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