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[Constrictive pericarditis after cardiac surgery]

J P Remadi1, O al Habash, C Bonnel

  • 1Clinique Chirurgicale Thoracique, Cardiaque et Vasculaire, Höpital G. et R. Laennec, Nantes.

Annales De Chirurgie
|January 1, 1996
PubMed
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Constrictive pericarditis is a rare cardiac surgery complication. Early diagnosis and pericardectomy can resolve symptoms, even when initial presentation mimics myocardial failure.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Constrictive pericarditis is a rare but serious complication following cardiac surgery.
  • This study investigates the incidence, presentation, and outcomes of constrictive pericarditis post-cardiac surgery.

Observation:

  • Five cases of constrictive pericarditis were identified among 7851 cardiac surgery patients (0.63% incidence).
  • Patients were male, with symptom onset a mean of 21 months post-surgery, primarily presenting with right ventricular failure.
  • Diagnosis was confirmed via right heart catheterization revealing a diastolic dip-plateau pattern.

Findings:

  • Radical pericardectomy was performed in four patients, with one managed medically.
  • All five patients experienced resolution of clinical signs after treatment.
  • The study highlights the diagnostic challenges due to non-specific symptoms mimicking myocardial failure.

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Implications:

  • Recognizing constrictive pericarditis is crucial for accurate diagnosis and effective management in post-cardiac surgery patients.
  • Timely surgical intervention (pericardectomy) can lead to favorable outcomes.
  • Clinicians should consider occult constriction in patients with unexplained heart failure symptoms after cardiac surgery.