Advanced effusive-constrictive pericarditis rescued by the aggressive waffle procedure

We report the case of a 68-year-old man with progressive heart failure due to effusive-constrictive pericarditis. During approximately 1 month, echocardiography revealed rapid progression from pericarditis with effusion without tamponade to pericardial thickening and diastolic dysfunction. Cardiac c...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2012-05, Vol.60 (5), p.297-301
Main Authors: Yamazaki, Kazuhiro, Marui, Akira, Nakahara, Takahiro, Saji, Yoshiaki, Nishina, Takeshi, Ikeda, Tadashi, Shizuta, Satoshi, Sakata, Ryuzo
Format: Article
Language:English
Subjects:
Aged
Cardiac Catheterization
Cardiopulmonary Bypass
Disease Progression
Echocardiography, Doppler
Heart Failure - diagnosis
Heart Failure - etiology
Heart Failure - surgery
Humans
Magnetic Resonance Imaging
Male
Pericardial Effusion - complications
Pericardial Effusion - diagnosis
Pericardial Effusion - surgery
Pericardiectomy
Pericardiocentesis
Pericarditis, Constrictive - complications
Pericarditis, Constrictive - diagnosis
Pericarditis, Constrictive - surgery
Predictive Value of Tests
Tomography, X-Ray Computed
Treatment Outcome
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Summary:We report the case of a 68-year-old man with progressive heart failure due to effusive-constrictive pericarditis. During approximately 1 month, echocardiography revealed rapid progression from pericarditis with effusion without tamponade to pericardial thickening and diastolic dysfunction. Cardiac catheterization revealed that the pressure in the right heart chambers remained high after pericardiocentesis. The patient was rescued by aggressive pericardiectomy and sharp dissection of the epicardium into small fragments. This on-pump beating-heart surgery is known as the waffle procedure.
ISSN:1863-6713
DOI:10.1007/s11748-011-0798-9