[A case of constrictive pericarditis after myocardial revascularization]

Area of Science:

• Cardiology
• Cardiac Surgery

Background:

• Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
• Complications following CABG can include pericardial issues.
• Constrictive pericarditis is a rare but serious condition affecting the heart's outer lining.

Observation:

• A patient developed pneumopericardium and pericardial effusion post-CABG, initially treated successfully.
• Symptoms of constrictive pericarditis, including fatigue and edema, emerged months later.
• The patient's coronary artery bypass graft remained patent throughout the observation period.

Findings:

• Constrictive pericarditis was diagnosed approximately 4 months after CABG.
• Initial pericardial stripping via median sternotomy provided temporary hemodynamic improvement.
• Recurrence of symptoms and abnormal right ventricular pressure tracings necessitated reoperation.

Implications:

• This case underscores the potential for delayed constrictive pericarditis after CABG.
• Surgical management of constrictive pericarditis may require staged or extended pericardiectomy.
• Prompt diagnosis and intervention are crucial for managing post-CABG constrictive pericarditis.