Chronic Constrictive Pericarditis: Hemodynamic Changes Following Pericardiectomy

Ten patients with chronic constrictive pericarditis underwent pericardiectomy at the University College Hospital, Ibadan, from July 1977 to May 1979. Preoperatively, right heart catheterization and angiocardiography were performed in seven patients. A significant decline in mean right atrial pressure occurred intraoperatively immediately after completion of decortication. Further measurements obtained in the immediate postoperative period identified two patient groups: one group of four patients with normal pressures and no mortality and one group of five patients with abnormal pressures and three deaths. Intraoperative pressure measurement at pericardiectomy is suggested as a useful parameter in identifying those patients with “reversible” myocardial dysfunction at risk from refractory cardiac failure in the postoperative period. Restoration of normal pressure after pericardiectomy is not dependent on the duration of disease.