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Constrictive pericarditis after surgical closure of atrial septal defect in a child
1Department of Pediatrics, Chonnam National University Medical School, Kwangju, Korea.
Insights
Constrictive pericarditis is a rare complication after congenital heart defect surgery in children. Early diagnosis and pericardiectomy can significantly improve patient outcomes and restore normal heart function.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Congenital Heart Disease
Background:
- Constrictive pericarditis is an uncommon complication following open cardiac surgery for congenital heart disease in pediatric patients.
- Postpericardiotomy syndrome can precede the development of constrictive pericarditis.
Observation:
- A 14-year-old boy developed constrictive pericarditis 22 months after surgical closure of an atrial septal defect.
- Clinical presentation included symptoms suggestive of postpericardiotomy syndrome.
Findings:
- Cardiac catheterization demonstrated uniformly elevated diastolic pressures across all cardiac chambers.
- Right atrial pressure tracing showed prominent x and y descents.
- Ventricular end-diastolic pressures exhibited a characteristic "dip and plateau" contour.
Implications:
- Pericardiectomy effectively improved the patient's hemodynamic status.
- Surgical intervention led to a symptom-free recovery during a 12-month follow-up period.
- This case highlights the importance of considering constrictive pericarditis in children with relevant surgical history presenting with cardiac dysfunction.
Abstract:
Constrictive pericarditis following an open cardiac surgery for congenital heart disease is very rarely encountered in children. We report a case of constrictive pericarditis, diagnosed at 22 months after surgical closure of an atrial septal defect, in a 14-year-old boy who presented postpericardiotomy syndrome. Cardiac catheterization revealed uniformity of elevated diastolic pressures in all chambers, prominent x and y descents in the right atrial pressure tracing, and typical "dip and plateau" contour of ventricular end-diastolic pressures. Pericardiectomy improved the hemodynamic status of the patient. He remains symptom-free during the follow-up period of 12 months.