积极的“华夫饼”手术挽救了晚期渗出性缩窄性心包炎。

Advanced effusive-constrictive pericarditis rescued by the aggressive waffle procedure.

作者信息

Yamazaki Kazuhiro, Marui Akira, Nakahara Takahiro, Saji Yoshiaki, Nishina Takeshi, Ikeda Tadashi, Shizuta Satoshi, Sakata Ryuzo

机构信息

Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-machi, Sakyo, Kyoto, 606-8507, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2012 May;60(5):297-301. doi: 10.1007/s11748-011-0798-9. Epub 2012 Mar 28.

DOI:10.1007/s11748-011-0798-9

PMID:22453540

Abstract

We report the case of a 68-year-old man with progressive heart failure due to effusive-constrictive pericarditis. During approximately 1 month, echocardiography revealed rapid progression from pericarditis with effusion without tamponade to pericardial thickening and diastolic dysfunction. Cardiac catheterization revealed that the pressure in the right heart chambers remained high after pericardiocentesis. The patient was rescued by aggressive pericardiectomy and sharp dissection of the epicardium into small fragments. This on-pump beating-heart surgery is known as the waffle procedure.

摘要

我们报告了一例68岁男性因渗出性缩窄性心包炎导致进行性心力衰竭的病例。在大约1个月的时间里，超声心动图显示病情迅速进展，从伴有积液但无心脏压塞的心包炎发展为心包增厚和舒张功能障碍。心导管检查显示心包穿刺术后右心腔压力仍居高不下。患者通过积极的心包切除术以及将心外膜锐性剥离成小碎片而获救。这种体外循环下的心脏不停跳手术被称为华夫手术。