MITRAL-INSUFFICIENCY AFTER PERICARDIECTOMY FOR CONSTRICTIVE PERICARDITIS

We report the case of a 24-year-old man in whom a clinical syndrome de veloped while he was on active military duty in Saudi Arabia that was subsequently diagnosed as constrictive pericarditis. Phrenic nerve to phrenic nerve pericardiectomy and posterior pericardial release succes sfully relieved the ventricular constriction with a resultant increase in the cardiac index from 1.9 to 3.8 L.min(-1).m(-2). Transesophageal echocardiographic monitoring during the operation disclosed trace mit ral regurgitation before median sternotomy. The severity of the regurg itation noticeably increased to the moderate level immediately after p ericardial resection. This echocardiographic finding had improved 1 we ek later, but the regurgitation still was greater than baseline. Mitra l valve function had returned to baseline by 4 weeks after the operati on. Possible mechanisms of this evolving pattern of perioperative mitr al valve dysfunction are discussed.