Chronic cardiac rejection masking as constrictive pericarditis

Thomas J. Hinkamp, Henry J. Sullivan, Alvaro Montoya, Soon Park, Linda Bartlett, Roque Pifarre

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


The hemodynamic changes consistent with constrictive pericarditis are often encountered in patients who have undergone cardiac transplantation. We describe here 4 patients who underwent pericardiectomy after cardiac transplantation. All were found to have evidence of a thickened and constricting peel of pericardium at surgical exploration. Their postoperative clinical courses were variable. One patient with primarily effusive constriction experienced marked improvement. Three patients failed to show clinical improvement and had persistently elevated atrial and ventricular end-diastolic pressures. A coexisting restrictive cardiomyopathy secondary to chronic rejection, coronary arteriopathy, or long-standing constriction may have been the cause of this poor outcome. Many patients with transplanted hearts exhibit evidence of poor diastolic ventricular compliance without evidence of classic constriction; some manifest both the restrictive and constrictive components. The careful selection of patients with constrictive pericarditis can optimize the outcome.

Original languageEnglish (US)
Pages (from-to)1579-1583
Number of pages5
JournalThe Annals of thoracic surgery
Issue number6
StatePublished - Jun 1994

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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