Waffle Procedure Improved Hemodynamic Circulation of Constrictive Epicarditis
10.4326/jjcvs.40.294
- VernacularTitle:Waffle procedure にて循環動態の改善を認めた収縮性心膜炎の1例
- Author:
Tomohiro Takano
;
Koki Takahashi
;
Masahiro Tanji
- Publication Type:Journal Article
- Keywords:
constrictive pericarditis;
pericardiectomy;
waffle procedure
- From:Japanese Journal of Cardiovascular Surgery
2011;40(6):294-297
- CountryJapan
- Language:Japanese
-
Abstract:
A 62-year-old woman who had suffered from malignant articular rheumatism since 2000 felt fatigue, exertional dyspnea and edema was admitted in May 2009. Cardiac catheterization demonstrated a dip-and-plateau pattern of the pressure curve of RV. Therefore we diagnosed constrictive pericarditis. She decided to have surgery as soon as possible. As she had also been troubled with constrictive pulmonary damage, chronic renal failure, and was taking an inotropic agent, we concluded that the use of extracorporeal circulation was risky. After median sternotomy, we recognized diastolic insufficiency of the heart due to hypertrophy of the epicardium. Using an ultrasonic scalpel and electrotome, we incised the thickened epicardium with a waffle procedure. The dip-and-plateau disappeared and as a result the cardiac index was improved immediately (1.9 l/min/m2→2.6 l/min/m2). She was discharged on postoperative day 25. In this way waffle procedure for constrictive pericarditis can an effective surgical procedure for a high risk patient.
