Document Detail

Cardiac decortication (epicardiectomy) for occult constrictive cardiac physiology after left extrapleural pneumonectomy.
MedLine Citation:
PMID:  12475875     Owner:  NLM     Status:  MEDLINE    
Constrictive cardiac physiology typically does not occur in the absence of parietal pericardium. However, we report eight patients who, after left extrapleural pneumonectomy and removal of the parietal pericardium for malignancy, presented with dyspnea, jugular venous distension, and peripheral or generalized edema unresponsive to diuretics. Cardiac decortication (epicardiectomy) was performed whereby a thickened peel encasing the heart was surgically excised, resulting in vigorous contraction and expansion of the heart. In one patient, decortication occurred early after pneumonectomy and was incomplete. Acute signs of inflammation were present, and recurrence necessitated repeat decortication. When patients present with dyspnea, hepatojugular reflux, and peripheral edema refractory to diuretics, constrictive cardiac physiology should be considered in the differential diagnosis, even in the absence of parietal pericardium.
John G Byrne; Alexandros N Karavas; Yolonda L Colson; Raphael Bueno; William G Richards; David J Sugarbaker; Samuel Z Goldhaber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  122     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-11     Completed Date:  2003-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2256-9     Citation Subset:  AIM; IM    
Cardiac Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA.
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MeSH Terms
Constriction, Pathologic
Heart / physiopathology*
Lung Neoplasms / surgery
Mesothelioma / surgery
Myocardium / pathology
Pericardium / surgery*
Postoperative Complications
Comment In:
Chest. 2003 Aug;124(2):770; author reply 771   [PMID:  12907578 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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