The Influence of Pericardiectomy on the Hemodynamics of Chronic Constrictive Pericarditis

Abstract

Preoperative and postoperative right heart catheterizations were performed on six patients with chronic constrictive pericarditis. Before surgery the patients characteristically showed distinct elevation of right ventricular end-diastolic, pulmonary arterial and wedge pressures. During the operation, right and left ventricular pressure curves were recorded both before and after pericardial resection. Before decortication, the average values of end-diastolic pressures for the right and left ventricles were 17 and 20 mm Hg respectively. No significant changes were observed after pericardiectomy was completed. However, all patients showed excellent clinical recoveries. Postoperative catheterizations performed two to five months after operation disclosed normal intracardiac pressures. Persistent impairment of ventricular performance in the early period after pericardiectomy must be attributed to a reversible myocardial failure.