Pericardial constriction after cardiac transplantation.
In this study we present a series of 5 cases that developed constrictive pericarditis after orthotopic heart transplantation. All 5 patients had pericardial effusion of non-infectious etiology in the early post-transplant period. They subsequently presented with heart failure unresponsive to standard medical management. The diagnosis was made by comprehensive echo-Doppler studies. Findings were confirmed at surgical inspection and complete pericardiectomy led to improvement in hemodynamics in 4 patients. One patient had relief from constriction but died of non-cardiac complications. One patient with constriction has been re-listed for transplantation due to intermittent heart block and associated cardiac allograft vasculopathy. Early diagnosis of pericardial constriction after orthotopic heart transplantation requires a high index of clinical suspicion and optimal use of Doppler echocardiography. Early diagnosis and timely surgical pericardiectomy may correct this condition entirely and result in satisfactory long-term results.
Bansal
Ramesh
R
Division of Cardiology, Loma Linda University School of Medicine, Loma Linda, California 92354, USA. rbansal@llu.edu
Perez
Leandro
L
Razzouk
Anees
A
Wang
Nan
N
Bailey
Leonard
L
D000328:Adult; D015150:Echocardiography, Doppler; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D010496:Pericardium / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome