Key result
Off-pump ultrasonic scalpel pericardiectomy safely relieves constrictive pericarditis in a patient 30 years post-surgery.
Case Report (n=1)
No
Pericardiectomy using an ultrasonic scalpel without cardiopulmonary bypass can safely treat constrictive pericarditis caused by calcification and organized hematoma decades after cardiac surgery.
Supports feasibility of ultrasonic scalpel pericardiectomy without bypass in late post-surgical constriction; hypothesis-generating pending controlled studies.
A 54-year-old man, who had undergone atrial septal defect (ASD) closure 30 years previously, was admitted for exertional dyspnea and chest oppression. He presented with right pleural effusion and hepatomegaly. Hemodynamic characteristics were consistent with constrictive pericarditis caused by multiple cystic lesions anterior to the main pulmonary artery and right ventricle, and severe calcification over the posterior and diaphragmatic sides of the heart. Magnetic resonance imaging was useful for differential diagnosis of the cystic mass and at surgery, it was revealed that the cystic lesions were old hematoma without cells. Pericardiectomy and removal of the calcification were performed safely using an ultrasonic scalpel, without cardiopulmonary bypass, resulting in hemodynamic improvement and relief of his symptoms.
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Takami et al. (2002) conducted a case report in Constrictive pericarditis (n=1). Pericardiectomy using an ultrasonic scalpel was evaluated on Hemodynamic improvement and symptom relief. Pericardiectomy using an ultrasonic scalpel without cardiopulmonary bypass safely relieved symptoms and improved hemodynamics in a patient with constrictive pericarditis 30 years post-cardiac surgery.
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