Localized constrictive pericarditis after Gore-Tex pericardial substitution.
A 65-year-old patient presented with recurrent cardiac decompensation 12 years after aortic prosthesis replacement and expanded polytetrafluoroethylene (ePTFE) membrane pericardial substitution. Diagnosis of pericardial constriction was difficult. Only one cardiac imaging method, radionuclide ventriculography, was helpful. Upon re-operation, an epicardial fibrous strap which restricted right ventricle (RV) diastolic expansion was found between the anterior free wall and diaphragmatic portion of the RV. Clinical status dramatically improved after surgical removal of this bridle, as did ventricular filling curves in radionuclide imaging. This case shows that delayed cardiac constriction is possible after ePTFE pericardial substitution, especially if the membrane is applied to both anterior and diaphragmatic aspects of the heart.
Bergoënd
Eric
E
Department of Cardiac Surgery, Centre Hospitalier Universitaire, University François-Rabelais, Tours, France. ebergoend@hotmail.com
Marchand
Michel
M
Casset-Senon
Danielle
D
Cosnay
Pierre
P
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery; D001705:Bioprosthesis; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D010494:Pericarditis, Constrictive / Q000209:etiology* / Q000601:surgery; D010496:Pericardium / Q000000981:diagnostic imaging / Q000601:surgery*; D011138:Polytetrafluoroethylene / Q000009:adverse effects* / Q000627:therapeutic use; D015635:Radionuclide Ventriculography; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology
D011138:Polytetrafluoroethylene