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Pericardial pathology detected preoperatively in a patient undergoing mitral valve repair: a case report

Masayuki Nishiyama1, Takayuki Okada2, Tadaaki Koyama2

  • 1Department of Cardiovascular Surgery, Kansai Medical University Hospital, 2-3-1, Shinmachi, Hirakata, 573-1191, Osaka, Japan. m.nishiyama721@gmail.com.

Journal of Cardiothoracic Surgery
|April 12, 2026
PubMed

Insights

Severe pericardial adhesions pose significant risks during cardiac surgery. Meticulous planning and careful dissection are crucial for patient safety and successful outcomes in complex cases.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Severe intrapericardial adhesions present a significant challenge in cardiac surgery.
  • These adhesions increase risks of cardiac injury, bleeding, and technical difficulties with cardiopulmonary bypass.

Purpose of the Study:

  • To report a case of cardiac surgery in a patient with severe pericardial adhesions.
  • To highlight the importance of preoperative planning and surgical strategy in managing such complex cases.

Main Methods:

  • A 74-year-old female with severe mitral regurgitation and suspected dense pericardial adhesions underwent median sternotomy.
  • The patient received mitral valve repair with artificial chordae and annuloplasty, plus tricuspid valve repair.
  • Intraoperative findings confirmed extensive adhesions requiring meticulous dissection.

Main Results:

  • The surgical procedure was completed without cardiac injury.
  • Postoperative mitral regurgitation improved significantly.
  • The patient experienced an uneventful recovery and was discharged on day 12.

Conclusions:

  • Severe pericardial adhesions significantly increase cardiac surgery complexity and risk.
  • Accurate preoperative assessment and tailored surgical strategies are vital for procedural safety and favorable outcomes.
Abstract

Keywords:
case reportpericardial adhesionspreoperative imaging findings

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