만성교적성심낭염에 대한 임상적 고찰

Abstract

authors encouutered 58 cases of chronic constrictive pericarditis, of which 45 cases were treated surgically at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center. Among the 45 cases operated on , the authors included 41 cases in this report whose records contained rather accurate informa tion on its preoperative status including laboratory findings, operative findings, operative procedures and postoperative results. There were 33 males among the 41 cases. The age ranged from 7 to 65 years with the average age of 23.2 years. Important clinical manifestations were exertional dyspnea in 38 cases, ascites in 30 cases, distant heart sound in 34 cases and hepatomegaly in all cases. El ect rocardiogram showed low voltage of QRS wave. T wave abnormalities, auricular fibrillation, conduction defect and others, in that order. Calcification in thickened pericardium was detected in 13 cases on chest roen tgenograms. Pericardiectomies were performed through sternal splitting in 37 cases and by left thoracotomy in the remaining 4 cases. Rather radical excision was made in 37 cases and partial excision of pericardium Over left ventircle was performed on 4 cases because of patients poor condition and technical problems. Two patients died On the operating table of massive hemorrhage due to right atrial laceration. There were 2 postoperative deaths due to acute cardiac dilatation and respiratory insufficiency with heart failure in both cases. The 37 cases that survived showed good postoperative cOurse with diminution or complete disappearance of symptoms and signs. Histopathological examination of the excised pericardia showed chronic non-specific pericarditis in 27 cases, tuberculous pericardi tis in 13 cases, and staphylococcal pericarditis in one case.