[A case of constrictive pericarditis after myocardial revascularization].

A case of constrictive pericarditis that occurred 4 months after CABG is reported. After undergoing CABG the patient developed pneumopericardium with a subsequent pericardial effusion, which were successfully treated with steroids and diuretics and the patient was discharged asymptomatic. About 3 months later easy fatiguability, abdominal bloating and pedal edema appeared, prompting him to undergo a thorough examination, which revealed the presence of constrictive pericarditis. At that time the graft was shown to remain patent. Eight months post CABG pericardial stripping was performed through a median sternotomy with confirmation of a fall in the CVP and PAP (diastolic) intraoperatively. Towards postoperative day 3, however, the CVP rose again with reappearance of abdominal bloating. Hence, cardiac catheterization was performed once again. The RV pressure tracing showed dip and plateau, and reoperation was performed. Pericardial stripping performed on the lateral and supradiaphragmatic sides of the left ventricle via a left anterior thoracotomy brought about a satisfactory hemodynamic improvement.