• Journal of Chest Surgery
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• v.36 no.8
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• pp.610-613
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• 2003

A 68-year-old man with constrictive pericarditis underwent pericardiectorny. 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 fold and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.973-978
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• 1991

From January, 1982, to December, 1990, 15 patients underwent pericardiectomy for chronic constrictive pericarditis on Department Of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University. There were 9 male and 6 female patients [male to female ratio was 1.5: 1] ranging from 15 years to 63 years old [mean age 35.0]. All patients underwent pericardiectomy through a median sternotomy, partial cardiopulmonary bypass was performed on two patients. There were 3 postoperative death [20%]. Six cases [40%] were tuberculous origin 5 cases [34%] were Idiopathic [nonspecific chronic inflammatory change was considered to idiopathic], 2 cases [13%] were malignant origin, 2 cases [13Yo] were pyogenic origin. Dyspnea on exertion was evident in all patients and abdominal distention, general weakness, palpitation, peripheral edema were found. Eleven patients showed low voltage of QRS wave, 7 patients showed diffuse ST-T wave change, 2 patients showed atrial fibrillation on EKG. There were 6 patient showed pericardial thickening, 5 patients showed evidence of restriction, 5 patients showed pericardial effusion, 4 patients showed low cardiac output on preoperative echocardiogram. Hemodynamic response to pericardiectomy were observed; preoperative CVP 26.8 cmH2O declined to 15.0 cmH2O. Preoperative NYHA Functional class showed class II - 1, class III - 10, class IV - 4, postoperative NYHA functional class showed class I - 7, class II - 4, class Ill - l.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.155-159
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• 2014

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.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.605-607
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• 2002

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.

• Journal of Chest Surgery
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• v.11 no.3
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• pp.273-280
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• 1978

19 chronic pericarditis patients reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 10 years from January of 1968 to January of 1978. 2. There were 14males and 5 females in this series. Range of age varied from 110 days to 61 years. 2. There were two hospital death, one expired 2 days and another 3 days after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factor. 2. Clinical and histological study showed tuberculous origin in 8 cases, nonspecific chronic inflammatory changes in 6 cases and pyogenic infection cases in 5 patients. 2. The postoperative complications were observed in 6 cases, and the most common was cardiac arrhythmia and wound infection. 2. The extent of pericardiectomy should be confined to the left and right ventricles to correct the hemodynamic anomaly in general. The results of this procedure has been satisfactory in 89 percent of the cases. 2. Optimal myocardial function in cases of constritive pericarditis was the key to the successful outcome of this procedure.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.537-541
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• 1985

Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.05a
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• pp.147-147
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• 2006

• Journal of Chest Surgery
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• v.27 no.7
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• pp.628-630
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• 1994

Chronic constrictive pericarditis is the end stage of a chronic inflammation that produces a fibrous, thich constricting pericardium with a limitation of a diastolic ventricular filling and eventually systolic ejection as well. We experienced a typical case of constrictive pericarditis and treated successfully by pericardiectomy.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.190-196
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• 1991

Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

• Journal of Veterinary Clinics
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• v.15 no.2
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• pp.339-345
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• 1998

This study was performed to investigate the effect of acupuncture in dogs with experimentally induced thoracic disease. Twenty four dogs and 16 cats for the heart study, were divided into four groups(each of 6 in dogs, each of 4 in cats): laserpuncture, electroacupuncture, acupuncture and control group. Heart disease was induced by partial pericardiectomy, and then treatment was done once daily for 4 days. The acupoints used were Xin-shu and Nei-guan. The effect of acupuncture was evaluated by clinical symptom, blood chemical values, electrocardiogram(ECG) and histopathological findings. In dogs, acupuncture group revealed relatively fast recovery and laserpuncture group revealed secondly fast recovery after treatment. In catsl lasewuncture group revealed relatively fast recover and acnpuncture group reveaBed secondly fast recovery after treatment Sixteen dogs for the lung study, were divided into flour groups(each of 4) : laserpuncture, electroacupunchuf, acupuncture and control group. Lung disease was induced by partial lung lobectomy, and then treatment was done once daily for 4 days. The acupoints used were Fei-shu and Shen- zhu. The effect of acupuncture was evaluated by clinical symptoms blood chemical values and histopathological findings. Acupuncture and laserpuncture group revealed relatively fast recovery compared with other groups.