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Mo A, Yang X. Pericardiectomy for a patient with constrictive pericarditis and multivessel coronary artery disease. Int J Surg Case Rep. 2018;49:231-234doi: 10.1016/j.ijscr.2018.06.034.
Mo, A., & Yang, X. (2018). Pericardiectomy for a patient with constrictive pericarditis and multivessel coronary artery disease. International journal of surgery case reports, 49231-234. https://doi.org/10.1016/j.ijscr.2018.06.034
Mo, Ansheng, and Yang, Xiaoping. "Pericardiectomy for a patient with constrictive pericarditis and multivessel coronary artery disease." International journal of surgery case reports vol. 49 (2018): 231-234. doi: https://doi.org/10.1016/j.ijscr.2018.06.034
Mo A, Yang X. Pericardiectomy for a patient with constrictive pericarditis and multivessel coronary artery disease. Int J Surg Case Rep. 2018;49:231-234. doi: 10.1016/j.ijscr.2018.06.034. Epub 2018 Jul 09. PMID: 30048912; PMCID: PMC6077153.
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Int J Surg Case Rep. 2018;49:231-234. doi: 10.1016/j.ijscr.2018.06.034. Epub 2018 Jul 09.

Pericardiectomy for a patient with constrictive pericarditis and multivessel coronary artery disease.

International journal of surgery case reports

Ansheng Mo, Xiaoping Yang

Affiliations

  1. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning 530023, China. Electronic address: [email protected].
  2. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning 530023, China.

PMID: 30048912 PMCID: PMC6077153 DOI: 10.1016/j.ijscr.2018.06.034

Abstract

INTRODUCTION: Pericardiectomy for patients with constrictive pericarditis and multivessel coronary artery disease is rare. Therefore, there is limited experience of pericardiectomy in these patients.

PRESENTATION OF CASE: We performed only pericardiectomy under the support of intra-aortic balloon pumping (IABP) for a patient with tuberculous constrictive pericarditis and multivessel coronary artery disease who refused to accept revascularization. The postoperative course was uneventful.

DISCUSSION: There is limited experience of pericardiectomy in patients with constrictive pericarditis and coronary artery disease, especially in those who want to perform only pericardiectomy and refuse to accept revascularization. There has only been one case report of a patient who had constrictive pericarditis and coronary artery disease, and hemodynamic instability postoperatively who did not have revascularization performed. Cardiopulmonary bypass facilitates dissecting grossly thickened pericardium off the heart and coronary artery exposure, but is associated with higher mortality and reoperation rates, renal failure, and atrial fibrillation. In our patient, cutting grossly thickened pericardium to expose the coronary artery under cardiopulmonary bypass was unnecessary because he refused to accept revascularization. Therefore, we performed only pericardiectomy under the support of IABP to avoid hemodynamic instability.

CONCLUSION: Performing only pericardiectomy under the support of IABP for a patient with constrictive pericarditis and multivessel coronary artery disease is safe and effective as long as the left ventricular ejection fraction is normal.

Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Constrictive pericarditis; Coronary artery disease; Intra-aortic balloon pumping; Pericardiectomy

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