title: Adjuvant Pericardial Sac Restraining in Heart Failure Treatment. A Medical Hypothesis Illustrated by a Case Report.
abstract: Ventricular constraint therapy has been used to prevent and reverse the progression of heart failure in ischemic and nonischemic cardiomyopathies. We hypothesized that ventricular restraint should be tried by closing the pericardium that was previously opened following left ventricle topographical projection. The surgical technique presentation is illustrated by a remarkable 13-year outcome of one patient with dilated cardiomyopathy treated surgically by mitral prosthesis, Cox/Maze III surgery to treat atrial fibrillation, and associated to the ventricular constraint using the patient's own pericardium. The ventricular pericardial restraint role is unclear, since the patient had multiple corrections that could be responsible for the good outcome; however it is viable deserving investigations.
authors.affiliation: Departament of Anatomy, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Paulo Roberto Barbosa
authors.initials: PR
authors.lastname: Evora
authors.affiliation: Departament of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Minna Moreira D
authors.initials: MM
authors.lastname: Romano
authors.affiliation: Departament of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Luis Gustavo
authors.initials: LG
authors.lastname: Gali
authors.affiliation: Departament of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: Departament of Anatomy, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
authors.forename: Alfredo José
authors.initials: AJ
authors.lastname: Rodrigues
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010496:Pericardium / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography