Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Heart Disease (Expert Forum)
constrictive pericarditis
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
constrictive pericarditis
by iowacr, Sep 01, 2008 02:16PM
Hi!
My husband 54 yr old had constrictive pericariditis 19 yr ago w/pericardectomy @ that time & has had ongoing problems re: to right heart failure. He has chronic renal insufficency and possible liver involvement. Now he is in the hospital with nausea, vomiting, weight loss, and altered mental status, he had an increase ammonia level.. He improved after TPN, lactulose. His fluid status is becoming increasingly difficult to control. He suffers from He is going to have a liver biopsy to assess the liver involvment. The dr. is suggesting a repeat pericardectomy. What are the risks with repeat pericardectomy? When they did his surgey the first time they said he still had a lot of calcification and they couldn't remove all of it. Are the surgical techniques improved to help remove the calcification/ If he doesn't have surgery are their other options?
My husband 54 yr old had constrictive pericariditis 19 yr ago w/pericardectomy @ that time & has had ongoing problems re: to right heart failure. He has chronic renal insufficency and possible liver involvement. Now he is in the hospital with nausea, vomiting, weight loss, and altered mental status, he had an increase ammonia level.. He improved after TPN, lactulose. His fluid status is becoming increasingly difficult to control. He suffers from He is going to have a liver biopsy to assess the liver involvment. The dr. is suggesting a repeat pericardectomy. What are the risks with repeat pericardectomy? When they did his surgey the first time they said he still had a lot of calcification and they couldn't remove all of it. Are the surgical techniques improved to help remove the calcification/ If he doesn't have surgery are their other options?
Doctor's Answer
by Cleveland Clinic, Sep 02, 2008 12:16PM
, Sep 02, 2008 12:16PM
Calcificantions make repeat pericardiectomy much more difficult and less successful. Unfortunately, this is the only option that he has at this point if the disease process is related to constriction. Sometimes that's difficult to prove. He should have a cardiac catheterization to look for pressure changes in both lower chambers of the heart to ensure that consitriction is the disease process at stake. Infrequently, advanced calcifications and inolvement of the ventricular wall may create a restrictive physiology that is very difficult to deal with surgically. Often times the surgeon won't even consider surgery in such a situation because of high risk. I am not aware of any new surgical techniques for pericardial disease.
