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At least 973 records · Page 54Linked to original sources
PubMed1997

[Constrictive pericarditis complicated with hepatic coma--a case report].

A 39-year-old man with pedal edema and icterus was admitted to our hospital. Laboratory findings revealed hyperbilirubinemia. Echocardiography and chest CT revealed the calcified mass front of the right ventricle. As cardiac catheterization showed dip and plateau in right ventricle, the diagnosis of constrictive pericarditis was established. Considering his condition and bleeding tendency with hepatic failure, plasma exchange was done for three days before operation. As the patient's condition deteriorated with hepatic coma, pericardiectomy was performed. The median sternotomy approach without cardiopulmonary bypass was selected. The calcified mass was removed, and the thickened pericardium was excised. Postoperative hemodynamic findings were improved, and the serum bilirubin returned to normal. In conclusion even in this case with severe hepatic failure due to constrictive pericarditis, surgical treatment should have be considered.

Adult↗
PubMed1996

[Post-radiotherapy pericarditis; a clinical and pathological study of 75 cases].

The outcome of 75 cases of post-radiotherapy pericarditis severe enough to lead to surgery, was reviewed from 1970 to September 1995. Four clinical forms were identified: acute pericarditis resistant to medical treatment (12 cases), large chronic pericardial effusions resistant to medical treatment (16 cases), chronic, compressive effusions (35 cases) and signs of pericardial constriction (12 cases). The medical conditions irradiated were Hodgkin's disease (41 cases), followed by carcinomas (27 cases), malignant lymphomas, thymoma and seminoma. Forty-three deaths were observed during the study period (only 4 unrelated to the neoplasia or radiotherapy) after a mean interval of 7.4 years after radiotherapy and 2.5 years after surgical biopsy: 25 were related to cardiopulmonary complications of radiotherapy: 14 were due to recurrence of the malignant disease or the appearance of another tumour. Fifty-two pericardial effusion drainage procedures and 28 pericardectomies were performed, due to the necessity for reoperation. The authors have tried to determine therapeutic indications based on recognised physiopathological data and the anatomical aspects of the four different clinical forms. The prognosis is affected by post-radiotherapy fibrosis which extends beyond the pericardium to involve other cardiac structures and the pulmonary parenchyma. However, it must be emphasised that the initial survival of all these patients was due to the radiotherapy.

Female↗
PubMed1997

[Acute effusive-constrictive pericarditis in influenza A].

Constrictive pericarditis may complicate the course of several viral infections, mainly Coxsackie virus group B, as well as in rheumatoid disease, radiation and neoplasm. Perimyocardial involvement during influenzal infections is usually mild and does not progress to constriction or tamponade. A single case of cardiac tamponade caused by influenza A was reported in 1986. We report a case of acute effusive-constrictive pericarditis due to influenza A infection. Corticosteroids resulted in some benefit, but did not relieve constriction, which required extensive pericardiectomy.

Adolescent↗
PubMed1997

[Anesthetic managements for pericardiectomy of three patients with constrictive pericarditis].

We experienced three patients with constrictive pericarditis who underwent pericardiectomy. Percutaneous cardiopulmonary support (PCPS) was carried out in two patients because of unstable hemodynamics caused by massive bleeding or cardiac compression due to surgical manipulation. In the other patient with severe tachycardia, we prepared PCPS before the induction of anesthesia, and could manage the whole course of anesthesia satisfactorily. It is suggested that PCPS is the most reliable way to support hemodynamics during anesthesia in patients with constrictive pericarditis.

Anesthesia↗
PubMed1997

[Long-term late results of pericardiectomy for constrictive pericarditis].

Twenty-four cases of the constrictive pericarditis were operated on pericardiectomy from 1966 to 1990. One case died because of massive bleeding, LOS, and respiratory failure immediately after the operation. A long-term follow up study was performed up to 27 years (mean 13.1 years) in other cases. Ten cases died during the follow up period (cardiac: 6, non cardiac: 4). Five cases of the cardiac deaths had major complications: tabes dorsalis, chronic respiratory failure, pacemaker implantation, mitral regurgitation, emergency operation at high age (78 years old). The survival rates of 5, 10, and 15 years were 85%, 67%, and 58.2%, respectively (Kaplan-Meier). All of survival cases are now in NYHA I or II class in satisfactory. We concluded that pericardiectomy is a very effective treatment for constrictive pericarditis but a more careful follow up is required especially in cases complicated with other major problems because cardiac function is not so recovered as normal level after surgery due probably to readhesion and fibrotic changes of the myocardium.

Adult↗
PubMedDate not supplied

[Acute pericarditis in childhood. The 9-year experience of a tertiary referral center].

Sixteen children, aged 7 months to 12 years, with acute pericarditis, admitted between 1985 and 1993 to a tertiary referral centre were analyzed retrospectively for their presentation, etiology, work-up, management and prognosis. It was found that most of the presenting signs were not specific and were often related to associated diseases such as respiratory tract infections. In 50% of the cases a cause was not found, the others had viral infections (12.5%), tuberculosis (12.5%), Haemophilus influenzae infection (6.25%), Toxocara canis infection (6.25%) and collagen diseases (12.5%). In eight cases non-steroidal anti-inflammatory drugs associated with steroids were given, 7 patients received non-steroidal anti-inflammatory drugs and 1 steroids. The mean follow-up time was 3 years (1 to 5). Six patients had one or more relapses. Five of the 6 patients with relapses were in the group which received steroids. The two patients with tuberculosis underwent pericardiectomy. One child died due to complex heart disease and the remaining 15 were cured. It was concluded that in pericarditis an extensive work-up may not reveal the major etiologies and that long term prognosis is good.

Acute Disease↗
PubMed1994

[Constrictive pericarditis--do we need a complete decortication?].

Pericardectomy is an established method for the treatment of various diseases, especially of constrictive pericarditis. Between 1969 and 1991, 212 cases of pericardial diseases were treated surgically. In 72 cases pericardectomy was performed for constrictive pericarditis. Surgical technique and indication for extracorporeal circulation are discussed. Postoperative haemodynamic problems were only seen in cases of preoperative advanced stage myocardial impairment. Extracorporeal circulation is only regarded as necessary in cases of strongly reduced myocardial function or if associated diseases need to be corrected.

Heart-Lung Machine↗
PubMed1997

[A case report of surgical treatment of constrictive pericarditis with coronary artery disease].

We performed the concomitant operation for constrictive pericarditis and coronary artery disease in an octogenarian. A 82-year-old male was hospitalized with dyspnea, edema of the lower extremities and pleural effusion on chest X-ray film. Cardiac catheterization revealed constrictive pericarditis and 75% stenosis of left anterior descending artery. Extensive pericardiectomy was performed including posterior wall of left ventricle and left atrium under the beating heart by using femoro-femoral partial bypass. Single CABG with a saphenous vein graft was performed following pericardiectomy. Postoperative cardiac catheterization showed good recovery of hemodynamics and patency of the bypass graft. Postoperative course was uneventful. The patient was discharged on twenty fifth postoperative day.

Aged↗
PubMed1997

[The waffle procedure (multiple incision of epicardium) with pericardiectomy for constrictive pericarditis].

Pericardiectomy is the only effective surgical procedure for constrictive pericarditis, but we have often experienced a lack of significant improvement of hemodynamic parameters, this being attributed to the presence of residual constriction. We have had two patients with constrictive pericarditis. In these patients, we decorticated the pericardium as usual, anterior to the bilateral phrenic nerves without cardiopulmonary bypass, and then, multiple longitudinal and transverse incisions were carefully made in the fibrous epicardium, avoiding the predicted course of major coronary branches and the myocardium. At the end of the procedure, the epicardial fibrous surface acquired a waffle-like appearance. With this maneuver, relief of constriction was achieved and the myocardium was able to reexpand, thus obtaining an adequate hemodynamic response. Our two patients recovered fully, and were discharged on the 18th and 19th postoperative day. They are presently free of clinical symptoms.

Aged↗
PubMed1998

Purulent pericarditis secondary to Candida parapsilosis and Peptostreptococcus species.

Purulent pericarditis secondary to Candida pericarditis is a rare but lethal infection. The first case of pericardial infection by Candida parapsilosis in combination with Peptostreptococcus species in an immunocompetent nondebilitated individual is reported. Urgent pericardiectomy was required after pericardial drainage failed to stop symptoms of tamponade. The etiology, microbiology and treatment of this unusual condition are reviewed.

Adult↗
PubMed1998

[A case of constrictive pericarditis reoperated 13 years after pericardiectomy by left thoracotomy approach].

A 48-year-old male with constrictive pericarditis was reoperated through median sternotomy 13 years after pericardiectomy through left thoracotomy. Extensive pericardiectomy is the most important point for constrictive pericarditis. Therefore, we have recently chosen the median sternotomy approach which has advantages over the left thoracotomy approach. Namely, the cardiopulmonary bypass is performed in the former approach immediately if the posterior pericardiectomy is difficult or the coronary arterial injury happens during decortication.

Humans↗
PubMed1998

[Acute pericarditis of unusual etiology].

Extrapulmonary manifestations of Legionella pneumophilia infection are infrequent. Cardiac involvement can occur. We observed an unusual case which led to acute pericarditis and reviewed the literature on cardiac involvement, particularly pericarditis, in patients which legionellosis.

Acute Disease↗
PubMed1998

[The evaluation of carcinoembryonic antigen determination in the pericardial fluid in the diagnosis of the cause of pericarditis].

Pericardial fluid CEA level was measured with radioimmunoassay in 19 patients with large pericardial effusion of unknown origin. In 11 patients malignancy was diagnosed. In all of these patients pericardial fluid CEA levels were above 7 ng/ml (mean value 52.6 +/- 42.6 ng/ml). In 8 patients the etiology of pericarditis was non-malignant. In all of them pericardial fluid CEA levels were below 7 ng/ml (mean value 2.2 +/- 1.6 ng/ml). In 9 patients with malignant pericarditis serum CEA levels were also determined: they were found to be lower than pericardial fluid CEA values in 6 patients. It was concluded that pericardial fluid CEA elevation is a reliable criteria of neoplastic pericardial involvement.

Carcinoembryonic Antigen↗
PubMed1998

Staphylococcus aureus pericarditis with tamponade complicating coronary angioplasty and stenting.

Infectious complications of coronary angioplasty and stenting are uncommon. A 70-year-old man is presented who underwent percutaneous transluminal coronary angioplasty (PTCA) and stenting of an occluded left anterior descending artery. This was complicated by Staphylococcus aureus pericarditis with tamponade. He was successfully treated with a closed drainage and antibiotics. This is the first reported case in the literature that documents purulent pericarditis and tamponade following percutaneous revascularization.

Aged↗
PubMed1998

[Cytarabine-induced pericarditis].

We report two cases of cytarabine (Ara-C) induced pericarditis. The first patient was a 61-year-old man with de novo acute myelogenous leukemia (AML) with trilineage myelodysplasia (M2). Fever and pericardial effusion developed after treatment with low-dose Ara-C and etoposide (VP16) during the patient's second leukemic relapse. The second patient was a 65-year-old man with myelodysplastic syndrome (MDS) transformed into AML (M2). He achieved a complete remission after treatment with low-dose Ara-C and VP16. However, during consolidation chemotherapy consisting of oral cytarabine ocfosfate and VP16, fever and pericardial effusion developed. In both cases, pericardiocentesis revealed exudative effusion with many neutrophils. Neither bacterial nor fungal infection was demonstrated. Chest symptoms and fever were resolved by methylprednisolone pulse therapy and pericardial drainage. Both patients were given a diagnosis of pericarditis caused by allergic reaction to Ara-C. We also report on 6 other patients with Ara-C syndrome who have been encountered by our hospital.

Aged↗
PubMed1998

[Renal microscopic polyarteritis replaced by pericarditis with episodic increases in MPO-ANCA in a patient with systemic lupus erythematosus].

A 41-year-old female was admitted to our hospital with acute renal failure. The renal biopsy showed focal necrotizing crescentic glomerulonephritis, and her serology revealed a high titer of MPO-ANCA. The diagnosis of MPO-ANCA-associated microscopic polyarteritis was made, and her basic illness proved to be systemic lupus erythematosus (SLE) because of renal injury, polyarteritis, pancytopenia, anti-double-strand DNA antibody, and anti-nuclear antibodies. After treatment with prednisolone (PSL) and cyclophosphamide, her renal function improved and her MOP ANCA titer was lowered. After 2 years, she was readmitted due to dyspnea. Chest X-ray and echocardiography revealed pericarditis and bilateral pleural effusion. Renal biopsy was carried out again because of an increase in MPO-ANCA, which showed minor abnormalities. PSL therapy led to remission of pericarditis, resulting in a decrease in MPO-ANCA. In this case, MPO-ANCA is likely to be associated not with the activity of polyarteritis, but with that of SLE, and care should be taken in evaluating the clinical usefulness of MPO-ANCA in cases with SLE.

Adult↗
PubMed2006

Experience with management of anterior abdominal wall defects using bovine pericard.

During 5 years from 1999 until 2003, our experience with 29 (100%) neonates managed for anterior abdominal wall defects is presented. Twenty-one (72%) neonates presented with gastroschisis and 8 (28%) neonates with giant omphaloceles. The male:female ratio was almost equal in gastroschisis (1:1) while a male predominance was observed in omphaloceles (6:1). A primary closure of the defect was possible in 5 (17%) cases and a single patch along with skin closure was achieved in a further 9 (31%) cases. In 15 (52%) neonates the defect was large and two patches were employed to sufficiently cover the defect. All patients (97%), except one (mortality due to extreme prematurity), were managed successfully. Depending upon the size of the defect and the metabolic condition of the neonate, the defect closure was completed after a mean of 85.7 days. Special protocols were created to manage the bovine pericard patches, which behaved differently to lyophilized dura patches previously used at our center. Integration of the patches was successful in 28 (97%) neonates; however, one neonate with gastroschisis presented significant challenges in the management. Bovine pericard patches are optimal biomaterials for the closure of anterior abdominal wall defects in gastroschisis and omphaloceles.

Abdominal Wall↗