Decortication of the Heart

Delorme,1in 1895, suggested that decortication of the heart should be undertaken much as is decortication of the lung for chronic empyema. Between the years 1895 and 1898, Delorme repeatedly addressed the Clinical Societies of Paris advocating a lysis of the intrapericardial adhesions followed by closure of the pericardium and later recommending actual excision of a portion of the pericardium. The latter operation is the one used today, which is in actuality a pericardiectomy used as the treatment for a constrictive pericarditis. Although the syndrome had been described, it remained for Volhard in 1923 to describe the exact physiology of this constrictive pericarditis and to employ the term inflow stasis. As it stands today, the treatment of constrictive pericarditis usually follows an infective pericarditis, which heals by scar and, often times, calcification; however, as skill in treating traumatic wounds of the chest is gained, the technique should be modified