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Ann Thorac Surg 2008;86:1994-1996. doi:10.1016/j.athoracsur.2008.05.005
© 2008 The Society of Thoracic Surgeons
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Takafumi Masai
Yoshiki Sawa
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Case Reports

Successful Surgical Management for Severe Mitral Regurgitation Unmasked After Pericardiectomy for Chronic Constrictive Pericarditis

Teruya Nakamura, MDa,*, Takafumi Masai, MDa, Takashi Yamauchi, MDa, Takahiro Higuchi, MDa, Hiroshi Ito, MDb, Yuko Toyoshima, MDb, Yoshiki Sawa, MDc

a Division of Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, Osaka, Japan
b Division of Cardiology, Sakurabashi-Watanabe Hospital, Osaka, Japan
c Department of Surgery, Osaka University Graduate School of Medicine, Suita, Japan

Accepted for publication May 5, 2008.

* Address correspondence to Dr Nakamura, Division of Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-Ward, Osaka, 530-0001, Japan (Email: teruyan{at}kure-nh.go.jp).

A 78-year-old cachectic woman who previously had repair of atrial septal defect was admitted to the hospital for congestive heart failure. Cardiac workup revealed chronic constrictive pericarditis; no evidence of coronary or valvular disease was found. She underwent corrective surgery for pericardiectomy. Intraoperative transesophageal echocardiography after pericardiectomy demonstrated acute development of severe mitral regurgitation, which was not preoperatively observed. She eventually required mitral valve replacement and tricuspid valve repair after conservative management failed. She recovered from the operation and was discharged. We believe that this is the first report of successful surgical management of mitral regurgitation that developed acutely after pericardiectomy.






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