Constrictive epicarditis after open heart surgery: the turtle cage operation.
A 60-year-old man developed constrictive epicarditis within 1 year after isolated mitral valve replacement (MVR). At reoperation, decortication of the thick epicardial layer resulted, impossible without a high risk of injury of the myocardium and major coronary arteries. Therefore, multiple longitudinal and transverse incisions were performed on the epicardial peel, which at the end acquired a turtle cage appearance allowing myocardial reexpansion, relief of constriction, and restoration of adequate hemodynamics.
Faggian
G
G
Department of Cardiovascular Surgery, University of Padova Medical School, Italy.
Mazzucco
A
A
Tursi
V
V
Bortolotti
U
U
Gallucci
V
V
D005355:Fibrosis; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D010490:Pericardial Effusion / Q000209:etiology / Q000601:surgery; D010492:Pericardiectomy / Q000379:methods*; D010494:Pericarditis, Constrictive / Q000209:etiology* / Q000601:surgery*; D010496:Pericardium / Q000473:pathology