Atrio-ventricular regurgitations in constrictive pericarditis: incidence and post-operative outcome.
We studied 33 surgically proven cases of constrictive pericarditis during the period 1989-1991 by color Doppler echocardiography and angiography to look for incidence and postoperative outcome of atrioventricular regurgitation. The mean age was 27.2 + 16.5 years (21 males, 12 females). There was a very high incidence of mitral (79%, trivial in 13, mild in 11 and moderate in 2) and tricuspid (73%, trivial in 7, mild and moderate in 6 each and severe in 5) regurgitation. There was good correlation between 'color Doppler' and angiography for detection and quantification of these regurgitations (r = 0.89 for mitral and 0.76 for tricuspid regurgitation, respectively). There were no preoperative clinical or hemodynamic predictors for the incidence or severity of these regurgitations. Immediate postoperative (7-10 days) evaluation by color Doppler did not show any change in these regurgitations. A follow-up study (by color Doppler and angiography) in 18 patients at a mean period of 229 + 105 days revealed regression of these regurgitations by at least 1 grade in 50% of patients. Patients with persisting regurgitations had persisting hemodynamic abnormality and relatively longer duration of symptoms. The presence of atrio-ventricular regurgitations should not be taken as evidence favoring diagnosis of restrictive cardiomyopathy and against that of constrictive pericarditis. The mechanism of these regurgitations is not clear to us.
Mantri
R R
RR
Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Radhakrishnan
S
S
Sinha
N
N
Goel
P K
PK
Bajaj
R
R
Bidwai
P S
PS
D000328:Adult; D000790:Angiocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D010494:Pericarditis, Constrictive / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*