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[A case of constrictive pericarditis following graft replacement of the descending aorta under left ventricular
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Insights
A rare case of constrictive pericarditis occurred after descending aorta replacement. This study reports the first documented instance of this complication following aortic graft surgery, detailing diagnosis and successful treatment.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Constrictive pericarditis is a potential complication after cardiac surgery, particularly following procedures involving cardiopulmonary bypass and cardiotomy.
- While theoretical links exist between left ventricular (LV) bypass with centrifugal pumps and pericarditis, clinical reports are scarce.
Observation:
- A 61-year-old male developed fever and heart failure three weeks post-descending aorta graft replacement via left thoracotomy.
- Diagnostic imaging, including chest CT and echocardiography, confirmed constrictive pericarditis.
Findings:
- Reoperation revealed significant pericardial adhesion to the anterior ventricular walls and the postero-lateral left ventricle.
- Surgical dissection of adhesions and resection of thickened pericardium were performed.
Implications:
- This case highlights constrictive pericarditis as a rare but serious complication following descending aorta replacement.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes in such cases.
Abstract:
We experienced a case of constrictive pericarditis following replacement of the descending aorta. It has been pointed out that constrictive pericarditis can be developed following LV bypass using centrifugal pump due to the cardiotomy. But no actual case has reported so far. The case was a 61-year-old man for whom graft replacement of the descending aorta through left thoracotomy was performed. Fever and heart failure was elicited 3 weeks after the operation, and he was diagnosed as constrictive pericarditis by chest CT and echocardiography. The reoperation was performed 39 days after the graft replacement. Anterior wall of the both ventricle and postero-lateral wall of the left ventricle were strongly adhered to the pericardium. The adhesion was entirely dissected and the thickened pericardium was resected. The post-operative course was uneventful and the patient was discharged 42 days after the reoperation.