Constrictive pericarditis is often accompanied with fibrothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective
symptoms.
We
experienced 4 cases of constrictive pericarditis combined with bilateral fibrothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time
through
anterolateral thoracotomy with sternal transection( 3 patients) and median sternotomy incision(1 patient). Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive
retraction
for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right
atrium,
SVC and IVC. (Korean J Thoracic Cardiovas Surg 1994; 27:793-7)
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