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Constrictive pericarditis following coronary-artery bypass grafting in a patient with chronic asymptomatic
Insights
Constrictive pericarditis, a rare surgical complication, can rapidly progress. Prompt pericardiectomy relieved symptoms and restored coronary artery bypass graft function.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
Background:
- Constrictive pericarditis is an uncommon but serious complication following cardiac surgery.
- Early identification of pericardial changes is crucial for patient outcomes.
Observation:
- A patient undergoing coronary artery bypass grafting was incidentally found to have asymptomatic pericardial thickening.
- This condition rapidly progressed to symptomatic constrictive pericarditis.
Findings:
- During pericardiectomy, significant fibrous tissue encasing a coronary artery bypass graft was identified.
- The affected graft was compromised, while other grafts remained patent.
Implications:
- This case highlights the potential for rapid progression of constrictive pericarditis post-cardiac surgery.
- Surgical intervention, including pericardiectomy, can effectively manage this complication and restore graft patency.
Abstract:
Constrictive pericarditis is a rare complication of open-heart surgery. We describe a patient who was found at the time of coronary artery bypass surgery to have asymptomatic pericardial thickening and subsequently developed rapidly progressive constrictive pericarditis. At operation for pericardiectomy, the bypass graft to the posterior descending coronary artery was found to be strangled by fibrous tissue while the remaining two bypass grafts were patent. Following pericardiectomy, the patient made a good recovery.