We study on 3 children pyopericarditis on July 1996 at the Thoracic and Cardiovascular Surgery Department Cho Ray Hospital. All of patients come from Pediatric Hospital. Diagnostic: pyopericarditis with pus from pericardiocentesis. Operation: largely pericardiectomy. Result: all patients are in good condition when they are discharge.
Myocarditis ; Pericardiocentesis ; Pericardiectomy ; surgery ; therapeutics ; child

Harmonic Scalpel(Ethicon Endo-Surgery, Cincinnati, OH) has many advantages including no muscular stimulation, low heat, less smoke, easy hemostasis using ultrasound and good operation field. In patient with constrictive pericarditis, Harmonic Scalpel was beneficial during pericardiectomy.
Hemostasis ; Hot Temperature ; Humans ; Pericardiectomy* ; Pericarditis, Constrictive ; Smoke ; Ultrasonography

OBJECTIVETo observe the hemodynamic changes in patients undergoing pericardiectomy at different operational stages.

METHODSTotally 16 consecutive patients receiving radical pericardiectomy were enrolled in this observational study. Hemodynamic variables were monitored continuously by pulse-indicated continuous cardiac output(PiCCO)system. Totally,three sets of intraoperative hemodynamic parameters were obtained at three different stages of pericardiectomy.

RESULTSDuring the pericardiectomy,the cardiac index[CI,(1.9±0.6),(2.7±0.6),(3.0±0.5)L·min(-1)·m(-2);P<0.05]and stroke volume index[SI,(22.5±8.7),(29.9±8.5),(30.1±8.5)dyn·s·cm(-5)·m(2);P<0.05]showed significant improvement,whereas central venous pressure[CVP,(17.1±5.0),(13.3±3.9),(12.3±3.0)mmHg;P<0.05]decreased significantly. Global end-diastolic volume index[GEDVi,(533±156),(580±153),(559±144)ml·m(-2);P<0.05]increased and stroke volume variation[SVV,(15.6±6.1)%,(10.8±4.2)%,(9.4±5.4)%;P<0.05]decreased intra-operatively. The majority of the above-mentioned hemodynamic improvements occurred after the resection of pericardium over the left ventricular outflow tract(LVOT).

CONCLUSIONSPiCCO system can serve as a reliable,less invasive hemodynamic monitoring method during pericardiectomy. Resection of the pericardium over the LVOT is the most important step of the pericardiectomy.

A clinical study was done on 16 cases of constrictive pericarditis admitted to National Medical Center, from january, 1970 to October, 1982, were reviewed, conclusion as follows: 1) The patients with constrictive pericarditis generally revealed clinical features of right heart failure but low incidence of its characteristic features. 2) Hemodynamic and echocardiographic examinations were much helpful in confirmation of clinical diagnosis. 3) pericardiectomy was highly succesful in achievement of clinical improvement.
Diagnosis ; Echocardiography ; Heart Failure ; Hemodynamics* ; Humans ; Incidence ; Pericardiectomy ; Pericarditis, Constrictive*

We report a case of circulatory collapse and cardiac arrest immediately after the patient was turned from the lateral decubitus position to the supine position following left pneumonectomy. Closed-chest resuscitation with medical and fluid interventions were inadequate. Emergency chest showed the deviation of heart to the left side and blunted apex. Left ventricular rupture during resuscitation was found subsequent thoracotomy. This rupture and inadequacy of closed-chest resuscitation were felt to be associated with the operative pneumonectomy and pericardiotomy.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart ; Heart Arrest ; Humans ; Pericardiectomy ; Pneumonectomy* ; Resuscitation ; Rupture* ; Shock ; Supine Position ; Thoracotomy ; Thorax

Desmoid tumors are benign neoplasms with high rates of recurrence. A case of huge desmoid tumor of the intrathoracic and intraabdominal space is presented. The patient was treated with resection, which involved hepatic left lobectomy and diaphragmatic resection and partial pericardiectomy and wedge resection of left lower lobe of lung. The resulting defect over the pericarium and diaphragm was reconstructed by bovine pericardium and Marlex mesh. Prevention of presumed local recurrence of desmoid tumors requires wide excision margin.
Diaphragm ; Fibromatosis, Aggressive* ; Humans ; Lung ; Pericardiectomy ; Pericardium ; Polypropylenes ; Recurrence ; Thoracic Neoplasms

A 68-year-old man with constrictive pericarditis underwent pericardiectomy. The pericardium was dissected with a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). The harmonic scalpel differs from electrocautery in that there is only a minimal transfer of energy and no transfer of electrical energy to the tissues. A significant decrease in intraoperative and possibly even postoperative heart rhythm disorders is to be expected, as there is no conduction of electricity. This new device has many advantages including no muscular stimulation, low heat, a smokeless field and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.
Aged ; Electricity ; Electrocoagulation ; Heart ; Hemostasis ; Hot Temperature ; Humans ; Lobeline ; Pericardiectomy* ; Pericarditis, Constrictive* ; Pericardium

We report aprimary malignant pericardial mesothelioma. Thirty-eight-year-old male patient complained of dyspnea and chest pain with left shoulder pain. At first, we thought it was because of tuberculous constrictive pericarditis and performed medical management for one and a half years. But, the above symptom recurred repeatedly; therefore we did pericardiectomy and diagnosed his case as malignant pericardial mesothelioma. Tumor was sticked to the myocardium and complete resection was impossible. He received postoperative chemoradiotherapy.
Chemoradiotherapy ; Chest Pain ; Dyspnea ; Humans ; Male ; Mesothelioma* ; Myocardium ; Pericardiectomy ; Pericarditis, Constrictive* ; Pericarditis, Tuberculous ; Pericardium ; Shoulder Pain

The purpose of this presentation is to demonstrate a good results of a second operation, the Waffle procedure, in a patient who did not improve following pericardiectomy. Incomplete parietal pericardiectomy, myocardial fiber atrophy, and unexpected restrictive cardiomyopathy can be considered when the patient's symptom does not improve after pericardiectomy is carried out. Constrictive epicarditis is always ruled out. In our case, the patient having constrictive pericarditis combined with pericardial effusion received a pericardiectomy. However, hemodynamics and symptoms of the patient following the operation did not improve. However, we experienced a good result following a second operation, the Waffle procedure.
Atrophy ; Cardiomyopathy, Restrictive ; Hemodynamics ; Humans ; Pericardial Effusion* ; Pericardiectomy ; Pericarditis ; Pericarditis, Constrictive ; Rabeprazole

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.
Cardiac Tamponade* ; Coinfection* ; Early Diagnosis ; Emergencies ; Middle Aged ; Gram-Positive Cocci ; Pericardiectomy ; Pericardiocentesis ; Pericarditis* ; Pericardium