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Surgical Treatment for Chronic Constrictive Pericarditis

ѿܰȸ 1961 3 3ȣ p.39 ~ 47
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Seven cases of chronic constrictive pericarditis and two case of acute suppurative pericarditis which had been treated surgically in surgical clinic of medical college, Yonse University from January 1958 to July 1960 are presented in this report.
In seven cases of chronic constrictive pericarditis, five cases of them showed marked improvement in clinical findings as well as the venous pressure after pericardiectomy was made. One operative death and one recurrence with eventual death were noted. Though one patient had a marked improvent in cardiac compression,(case No. 5) she was complicated with cerebral embolism associated with right hemiplegia postoperatively.
The possible cause of cerebral embolism was incidental rupture of left a trial appendage on decortication.
Pathological findings in seven cases of chronic constrictive pericarditis showed 4 cases of tuberculosis, and 3 cases of nonspecific chronic inflammation.
In our experience, it was very hard to determine the activity of the pericardial lesion which was thought to be important for timing of successful pericardiectomy, by mean of clinical course and laboratory findings preoperatively.
For two cases of acute suppurative pericarditis pericardietomy with drainage was employed with satisfactory result, though transient aggravation in cardiac temponade occured about two weeks after operation.
Review of the literature concerning etiology, diagnosis, right heart cathterization, timing of operation and technique of pericardiectomy for chronic consistrictive pericarditis is reported.