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Clinical Cardiology Sep 1998Constrictive pericarditis after coronary artery bypass grafting (CABG) is rare and can present as unexplained dyspnea. We report five consecutive cases of post-CABG...
Constrictive pericarditis after coronary artery bypass grafting (CABG) is rare and can present as unexplained dyspnea. We report five consecutive cases of post-CABG constrictive pericarditis seen within a period of 17 months at our institution. All patients presented with heart failure of unknown etiology within a period of 8-84 months after surgery. During the initial post-CABG period, two patients had developed postcardiotomy syndrome that was successfully treated with steroids. They were all assessed noninvasively and invasively. In all patients, the diagnosis of constriction was initially suspected clinically (symptoms, high jugular venous pressure with deep "X" and "Y" descents, pericardial knock). Echocardiography showed transmitral flow typical of constriction in all patients and hepatic venous flow in two. Two patients showed rapid left ventricular relaxation. In all patients, hemodynamic assessment showed diastolic equalization of pressures in all chambers, "W" shape waveform in right atrial pressure, and "dip and plateau" configuration in right and left ventricular pressure waveforms. Diagnosis was confirmed surgically in four patients who were subjected to pericardiectomy-pericardial stripping (three survived, one died). One patient refused surgery. We conclude that constrictive pericarditis, although rare, should be suspected in every case of unexplained dyspnea post CABG. It can appear early or late after surgery, and clinical examination plays an important role in its early recognition. It requires a full noninvasive and invasive assessment in case of clinical suspicion.
Topics: Aged; Cardiac Catheterization; Coronary Angiography; Coronary Artery Bypass; Dyspnea; Echocardiography; Echocardiography, Transesophageal; Fatal Outcome; Female; Humans; Male; Middle Aged; Pericardiectomy; Pericarditis, Constrictive
PubMed: 9755389
DOI: 10.1002/clc.4960210917 -
BioMed Research International 2016Absorbable extracellular matrix (ECM) membrane has recently been used as a barrier membrane (BM) in guided tissue regeneration (GTR) and guided bone regeneration (GBR)....
Absorbable extracellular matrix (ECM) membrane has recently been used as a barrier membrane (BM) in guided tissue regeneration (GTR) and guided bone regeneration (GBR). Absorbable BMs are mostly based on collagen, which is more biocompatible than synthetic materials. However, implanted absorbable BMs can be rapidly degraded by enzymes in vivo. In a previous study, to delay degradation time, collagen fibers were treated with cross-linking agents. These compounds prevented the enzymatic degradation of BMs. However, cross-linked BMs can exhibit delayed tissue integration. In addition, the remaining cross-linker could induce inflammation. Here, we attempted to overcome these problems using a natural ECM membrane. The membrane consisted of freshly harvested porcine pericardium that was stripped from cells and immunoreagents by a cleaning process. Acellular porcine pericardium (APP) showed a bilayer structure with a smooth upper surface and a significantly coarser bottom layer. APP is an ECM with a thin layer (0.18-0.35 mm) but with excellent mechanical properties. Tensile strength of APP was 14.15 ± 2.24 MPa. In in vivo experiments, APP was transplanted into rabbit tibia. The biocompatible material was retained for up to 3 months without the need for cross-linking. Therefore, we conclude that APP could support osteogenesis as a BM for up to 3 months.
Topics: Animals; Biological Products; Disease Models, Animal; Extracellular Matrix; Osteogenesis; Pericardium; Rabbits; Swine; Tibia
PubMed: 27047963
DOI: 10.1155/2016/6715295 -
Postgraduate Medical Journal Jul 1987A 14 year old girl presented with cardiac tamponade due to a haemorrhagic pericardial effusion. Systemic lupus erythematosus was diagnosed. Pericardial stripping was...
A 14 year old girl presented with cardiac tamponade due to a haemorrhagic pericardial effusion. Systemic lupus erythematosus was diagnosed. Pericardial stripping was performed due to recurrence of the effusion despite pericardiocentesis and steroid therapy.
Topics: Adolescent; Cardiac Tamponade; Female; Humans; Lupus Erythematosus, Systemic; Pericardial Effusion
PubMed: 3658866
DOI: 10.1136/pgmj.63.741.567