A case of effusive-constrictive pericarditis after cardiac surgery.
A case of effusive-constrictive pericarditis after cardiac surgery.
复制标题
心脏手术后渗出性缩窄性心包炎一例。
DOI：
10.4065/76.5.555
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发表时间：
2001
影响因子：
8.9
通讯作者：
Y. Aizawa
中科院分区：
文献类型：
--
作者：
M. Ito;Y. Tanabe;K. Suzuki;M. Kumakura;K. Nakayama;H. Kanazawa;Y. Yamazaki;Y. Aizawa
一位60岁女性，曾接受房间隔缺损修补术，术后31个月因呼吸困难、腹胀和腿部水肿再次入院。超声心动图显示大量心包积液。心导管检查显示4腔舒张压升高和平衡，右心室和左心室压力呈下降和平台模式。尽管通过心包穿刺术清除了心包积液，但结果和症状并未改善。病人接受了心包壁层和心包脏层切除术，术后血流动力学和症状明显改善。渗出性缩窄性心包炎并不常见，但在顽固性心力衰竭和大量心包积液的患者中应考虑心包积液，心包积液清除后无改善。
A 60-year-old woman who had undergone repair of an atrial septal defect was readmitted to the hospital with dyspnea, abdominal distention, and leg edema 31 months after surgery. An echocardiogram demonstrated massive pericardial effusion. Cardiac catheterization revealed elevation and equilibrium of the 4-chamber diastolic pressure and a dip-and-plateau pattern in the right and the left ventricular pressures. Despite removal of pericardial fluid by pericardiocentesis, the findings and symptoms did not improve. The patient underwent both parietal and visceral pericardiectomy after which striking hemodynamic and symptomatic improvement occurred. Effusive-constrictive pericarditis is uncommon but should be considered in patients with refractory heart failure and massive pericardial effusion showing no improvement after removal of pericardial fluid.