title: [Surgical Repair of Severely Calcific Constrictive Pericarditis;Report of a Case].
abstract: A 74-year-old male presented with exertional dyspnea and leg edema. Chest X-ray and computed tomography demonstrated dense calcification of the pericardium. Based on a diagnosis of constrictive pericarditis, pericardiectomy was performed without the use of extracorporeal circulation. During the operation, we employed a Harmonic Scalpel (Naginata-type) to peel off the calcified pericardium around the right and left ventricles. The calcified pericardium around the right atrium was found to be so firmly adhered to the atrial wall that peeling off the calcified tissue was difficult. Therefore, we used a Cavitron Ultrasonic Surgical Aspirator (CUSA) to break down the calcification. After the surgery, the patient's dyspnea on exertion and leg edema resolved, and he recovered without any complications. Regarding the surgical treatment of severely calcific constrictive pericarditis, Naginata-type Harmonic Scalpel and CUSA are very useful for peeling off the calcified tissue of the pericardium and/or breaking down the calcification.
authors.affiliation: Department of Cardiovascular Surgery, Shin-Koga Hospital, Kurume, Japan.
authors.forename: Motonori
authors.initials: M
authors.lastname: Uchino
authors.forename: Masaru
authors.initials: M
authors.lastname: Yoshikai
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sato
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D010492:Pericardiectomy / Q000295:instrumentation / Q000379:methods; D010494:Pericarditis, Constrictive / Q000150:complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome