title: Anti-inflammatory properties of amniotic membrane patch following pericardiectomy for constrictive pericarditis.
abstract: BACKGROUND
  Since constrictive pericarditis is most often idiopathic and the pathophysiology remains largely unknown, both the diagnosis and the treatment can be challenging. However, by definition, inflammatory processes are central to this disease process. Amniotic membrane patches have been shown to possess anti-inflammatory properties and are believed to be immune privileged. Due to these properties, amniotic membrane patches were applied intraoperatively in a complicated patient presenting with constrictive pericarditis.
  
  
  METHODS
  A patient with a history of multiple cardiac surgeries presented with marked fatigue, worsening dyspnea and sinus tachycardia. He was found to have constrictive physiology during cardiac catheterization, with cardiac MRI demonstrating hepatic vein dilatation, atrial enlargement and ventricular narrowing. After amniotic membrane patch treatment and pericardiectomy, post-operative cardiac MRI failed to demonstrate any appreciable pericardial effusion or inflammation, with no increased T2 signal that would suggest edema.
  
  
  CONCLUSIONS
  Given the positive results seen in this complex patient, we suggest continued research into the beneficial properties of amniotic membrane patches in cardiac surgery.
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, 1501 North Campbell Avenue, Room 4302, Tucson, AZ, 85724, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Marsh
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, 1501 North Campbell Avenue, Room 4302, Tucson, AZ, 85724, USA.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ferng
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, 1501 North Campbell Avenue, Room 4302, Tucson, AZ, 85724, USA.
authors.forename: Tia
authors.initials: T
authors.lastname: Pilikian
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Arizona College of Medicine, Tucson, USA.
authors.forename: Ankit A
authors.initials: AA
authors.lastname: Desai
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, Tucson, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Avery
authors.affiliation: Department of Internal Medicine, Division of Cardiology, University of Arizona College of Medicine, Tucson, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, Tucson, USA.
authors.forename: Isabel
authors.initials: I
authors.lastname: Oliva
authors.affiliation: Department of Medical Imaging, University of Arizona College of Medicine, Tucson, USA.
authors.forename: Clint
authors.initials: C
authors.lastname: Jokerst
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, 1501 North Campbell Avenue, Room 4302, Tucson, AZ, 85724, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schipper
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona College of Medicine, 1501 North Campbell Avenue, Room 4302, Tucson, AZ, 85724, USA. zkhalpey@surgery.arizona.edu.|Department of Medical Imaging, University of Arizona College of Medicine, Tucson, USA. zkhalpey@surgery.arizona.edu.|Department of Physiological Sciences, University of Arizona College of Medicine, Tucson, USA. zkhalpey@surgery.arizona.edu.|Department of Biomedical Engineering, University of Arizona College of Medicine, Tucson, USA. zkhalpey@surgery.arizona.edu.|Department of Translational and Regenerative Medicine, University of Arizona College of Medicine, Tucson, USA. zkhalpey@surgery.arizona.edu.
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
mesh_terms: D000328:Adult; D000650:Amnion / Q000502:physiology / Q000637:transplantation*; D006801:Humans; D007249:Inflammation / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D010490:Pericardial Effusion / Q000601:surgery; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000503:physiopathology / Q000601:surgery*
keywords: Amniotic membrane patch; Constrictive pericarditis; Orthotopic heart transplant