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[Constrictive pericarditis complicated with hepatic coma--a case report]

K Nakamura1, H Ohuchi, I Fukuda

  • 1Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Ibaraki, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|February 1, 1997
PubMed
Summary
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Constrictive pericarditis with severe hepatic failure can be treated surgically. Pericardiectomy improved hemodynamics and liver function, demonstrating surgical viability.

Area of Science:

  • Cardiology
  • Hepatology
  • Thoracic Surgery

Background:

  • Constrictive pericarditis can lead to hepatic dysfunction.
  • Severe hepatic failure presents a challenge for surgical intervention.

Observation:

  • A 39-year-old male presented with pedal edema, icterus, and hyperbilirubinemia.
  • Imaging revealed a calcified mass near the right ventricle, and cardiac catheterization indicated constrictive pericarditis.
  • The patient experienced hepatic coma, necessitating urgent intervention.

Findings:

  • Plasma exchange was performed prior to pericardiectomy due to bleeding tendency and hepatic failure.
  • Surgical pericardiectomy was successfully performed via median sternotomy without cardiopulmonary bypass.
  • Postoperative recovery showed improved hemodynamics and normalization of serum bilirubin levels.

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Implications:

  • Surgical pericardiectomy is a viable treatment option for constrictive pericarditis, even in patients with severe hepatic failure.
  • Early surgical consideration may prevent irreversible hepatic damage.
  • This case highlights the importance of a multidisciplinary approach in managing complex cardiac and hepatic conditions.