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. 2011 May;41(5):283-6.
doi: 10.4070/kcj.2011.41.5.283. Epub 2011 May 31.

Transient right ventricular dysfunction after pericardiectomy in patients with constrictive pericarditis

Hee Tae Yu  1 , Jong-Won Ha, Sak Lee, Chi Young Shim, Jeonggeun Moon, In-Jeong Cho, Min-Kyung Kang, Woo-In Yang, Donghoon Choi, Namsik Chung
Affiliations

Transient right ventricular dysfunction after pericardiectomy in patients with constrictive pericarditis

Hee Tae Yu et al. Korean Circ J. 2011 May.

Abstract

Pericardiectomy is the standard treatment in patients with chronic constrictive pericarditis who have persistent symptoms. However, myocardial atrophy with prolonged pericardial constriction and abrupt increase in venous return can lead to heart failure with volume overload after pericardial decompression, especially in the right ventricle (RV). We experienced a 44 year old male patient who developed transient RV failure after pericardiectomy for constrictive pericarditis. Echocardiography revealed a markedly dilated RV with decreased peak systolic velocity of the tricuspid annulus, suggesting severe RV dysfunction. After treatment with inotropics and diuretics, a follow-up echocardiography revealed an improved systolic function with decreased RV chamber size. This case demonstrates the importance of volume overload and RV dysfunction in patients with constrictive pericarditis undergoing pericardiectomy.

Keywords: Constrictive pericarditis; Pericardiectomy; Right ventricular dysfunction.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Left ventricular tissue Doppler image shows preserved early diastolic mitral annular velocity (E') on preoperative echocardiography (A), decreased E' on postoperative (B) and 7 months follow up echocardiography (C).
Fig. 2
Fig. 2
Right ventricular tissue Doppler image shows normal tricuspid annular velocity (S') on preoperative echocardiography (A), reduced S' on postoperative echocardiography (B), and slightly increased S' on echocardiography of 7 months follow up (C).
Fig. 3
Fig. 3
Two-dimensional echocardiography of the parasternal short-axis view (A, C and E) and apical 4-chamber view (B, D and F). The echocardiography showed pericardial thickening and relatively small sized RV (end-diastolic volume: 34.6 mL) at admission (A and B). Postoperative echocardiography revealed markedly dilated RV (end-diastolic volume: 85.6 mL) with D-shaped LV (C and D). The RV size was decreased (end-diastolic volume: 59.7 mL) on echocardiography after 7 months (E and F). RV: right ventricle, LV: left ventricle.
See this image and copyright information in PMC

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