@article{10.11648/j.js.20160406.11,
  author = {Ciss Amadou Gabriel and Gandji E.Wilfried and Diop Momar Sokhna and Ba Papa Salmane and Leye Mohamed and Sene Etienne Birame and Diatta Souleymane and Gaye Magaye and Dieng Papa Adama and N’diaye Assane and N’diaye Mouhamadou},
  title = {The Panzer Heart: A Surgical Challenge},
  journal = {Journal of Surgery},
  volume = {4},
  number = {6},
  pages = {126-129},
  doi = {10.11648/j.js.20160406.11},
  url = {https://doi.org/10.11648/j.js.20160406.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160406.11},
  abstract = {Introduction constrictive pericarditis is an inflammation of pericardium, they develops progressive fibrotic, calcified the pericardium and compressed the myocardium. The aim of this study is to present a case of massive calcified pericardium and to describe the difficult of surgery. Method A 30–year-old woman was admitted in cardiovascular hospital after 7 years of dyspnea, weakness, fatigue, ascites and palpitation. She had been diagnosed with on tuberculosis 8 years before and had complied with anti-tuberculosis chemotherapy. Treatment consists of 4 drugs therapy (rifampicin, isoniazid, pyrazinamide and ethambutol) for 2 months followed by 2 drugs (rifampicin, isoniazid) for 4 months with adjuvant treatment including vitamin B. Clinical examination showed symptoms of right heart congestion including congestive liver; ascites dilated jugular vein and leg edema. Chest radiography showed massive pericardial calcific deposits encircling the left and the right ventricle. Two dimensional echocardiography revealed severe pericardial calcification with right systolic ventricular dysfunction, dilatation fright atrium and inferior vena cava. Chest thoracic scanner was performed and precise the topography of calcification. Right cardiac catheterism was not performed. Abdominal ultrasound showed ascites and cardiac-like liver. The transaminases were high. Result A subtotal pericardiectomy was performed through a median sternotomy without cardiopulmonary bypass (CPB).The anterior, lateral and inferior pericardium was resected between the right and left phrenic nerve using the ultrasonic scalpel. Massive calcified are as were first irrigated with hot physiologic serum, in order to fracture the plaque and dissect it from myocardium without coronary lesion. Our patient was discharged to the hospital 8 days later, electrocardiogram showed atrial fibrillation. After 3 months she no longer presents dyspnea and ascites. Conclusion Surgical decompression of right cardiac cavities in massive calcified pericarditis induce increasing of right signs and restoration of the right ventricular function.},
 year = {2016}
}

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TY  - JOUR
T1  - The Panzer Heart: A Surgical Challenge
AU  - Ciss Amadou Gabriel
AU  - Gandji E.Wilfried
AU  - Diop Momar Sokhna
AU  - Ba Papa Salmane
AU  - Leye Mohamed
AU  - Sene Etienne Birame
AU  - Diatta Souleymane
AU  - Gaye Magaye
AU  - Dieng Papa Adama
AU  - N’diaye Assane
AU  - N’diaye Mouhamadou
Y1  - 2016/11/07
PY  - 2016
N1  - https://doi.org/10.11648/j.js.20160406.11
DO  - 10.11648/j.js.20160406.11
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 126
EP  - 129
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20160406.11
AB  - Introduction constrictive pericarditis is an inflammation of pericardium, they develops progressive fibrotic, calcified the pericardium and compressed the myocardium. The aim of this study is to present a case of massive calcified pericardium and to describe the difficult of surgery. Method A 30–year-old woman was admitted in cardiovascular hospital after 7 years of dyspnea, weakness, fatigue, ascites and palpitation. She had been diagnosed with on tuberculosis 8 years before and had complied with anti-tuberculosis chemotherapy. Treatment consists of 4 drugs therapy (rifampicin, isoniazid, pyrazinamide and ethambutol) for 2 months followed by 2 drugs (rifampicin, isoniazid) for 4 months with adjuvant treatment including vitamin B. Clinical examination showed symptoms of right heart congestion including congestive liver; ascites dilated jugular vein and leg edema. Chest radiography showed massive pericardial calcific deposits encircling the left and the right ventricle. Two dimensional echocardiography revealed severe pericardial calcification with right systolic ventricular dysfunction, dilatation fright atrium and inferior vena cava. Chest thoracic scanner was performed and precise the topography of calcification. Right cardiac catheterism was not performed. Abdominal ultrasound showed ascites and cardiac-like liver. The transaminases were high. Result A subtotal pericardiectomy was performed through a median sternotomy without cardiopulmonary bypass (CPB).The anterior, lateral and inferior pericardium was resected between the right and left phrenic nerve using the ultrasonic scalpel. Massive calcified are as were first irrigated with hot physiologic serum, in order to fracture the plaque and dissect it from myocardium without coronary lesion. Our patient was discharged to the hospital 8 days later, electrocardiogram showed atrial fibrillation. After 3 months she no longer presents dyspnea and ascites. Conclusion Surgical decompression of right cardiac cavities in massive calcified pericarditis induce increasing of right signs and restoration of the right ventricular function.
VL  - 4
IS  - 6
ER  - 

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