Our Summary

This research paper is about a patient who had two serious conditions: constrictive pericarditis, a condition where the protective sack around the heart becomes rigid and hard, and liver cirrhosis, a late stage of scarring of the liver. The patient successfully underwent an operation called off-pump radical pericardiectomy, a surgery to remove the rigid sack around the heart, without the use of a heart-lung machine. After the operation, the patient’s heart function greatly improved and there were no severe complications. The study highlights that this type of surgery can be effective for patients suffering from both constrictive pericarditis and liver cirrhosis.

FAQs

  1. What is off-pump radical pericardiectomy and how is it useful for treating constrictive pericarditis with liver cirrhosis?
  2. What improvements in cardiac parameters were observed after the pericardiectomy?
  3. Are there any severe complications associated with off-pump radical pericardiectomy?

Doctor’s Tip

A doctor may advise a patient undergoing pericardiectomy to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually increasing activity levels as directed by their healthcare team. It is important to communicate any concerning symptoms or changes in health to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for pericardiectomy include those with severe calcified constrictive pericarditis, especially if they are experiencing symptoms such as shortness of breath, chest pain, fatigue, and edema. Patients with conditions such as liver cirrhosis may also benefit from pericardiectomy if they are experiencing complications related to constrictive pericarditis. Pericardiectomy may be recommended for patients who have not responded to medical management or other interventions, and who are deemed suitable candidates for surgery based on their overall health and risk factors.

Timeline

Before pericardiectomy:

  • Patient presents with symptoms such as chest pain, shortness of breath, and fatigue
  • Diagnostic tests such as echocardiography, CT scan, and MRI reveal severely calcified constrictive pericarditis
  • Patient is evaluated by a cardiac surgeon and deemed a candidate for pericardiectomy

After pericardiectomy:

  • Patient undergoes off-pump radical pericardiectomy surgery
  • Cardiac parameters significantly improve post-surgery
  • Patient is closely monitored for any complications
  • Patient undergoes rehabilitation and follow-up appointments to monitor recovery and cardiac function.

What to Ask Your Doctor

  1. What is a pericardiectomy and why is it necessary for my condition?
  2. What are the risks and potential complications associated with pericardiectomy surgery?
  3. How long is the recovery process after a pericardiectomy?
  4. Will I need any additional follow-up care or treatment after the surgery?
  5. How will a pericardiectomy improve my symptoms and quality of life?
  6. Are there any alternative treatments or procedures available for my condition?
  7. What are the success rates for pericardiectomy surgery in patients with liver cirrhosis?
  8. Will I need to make any lifestyle changes or take any medications after the surgery?
  9. How long do the effects of a pericardiectomy typically last?
  10. Are there any specific precautions or restrictions I should be aware of post-surgery?

Reference

Authors: Hamada Y, Toda K, Kashiyama N, Miyagawa S, Sawa Y. Journal: JACC Case Rep. 2021 May 19;3(5):816-817. doi: 10.1016/j.jaccas.2021.03.024. eCollection 2021 May. PMID: 34317632