Pericardial constriction after cardiac transplantation

J Heart Lung Transplant. 2010 Mar;29(3):371-7. doi: 10.1016/j.healun.2009.07.015. Epub 2009 Oct 4.


In this study we present a series of 5 cases that developed constrictive pericarditis after orthotopic heart transplantation. All 5 patients had pericardial effusion of non-infectious etiology in the early post-transplant period. They subsequently presented with heart failure unresponsive to standard medical management. The diagnosis was made by comprehensive echo-Doppler studies. Findings were confirmed at surgical inspection and complete pericardiectomy led to improvement in hemodynamics in 4 patients. One patient had relief from constriction but died of non-cardiac complications. One patient with constriction has been re-listed for transplantation due to intermittent heart block and associated cardiac allograft vasculopathy. Early diagnosis of pericardial constriction after orthotopic heart transplantation requires a high index of clinical suspicion and optimal use of Doppler echocardiography. Early diagnosis and timely surgical pericardiectomy may correct this condition entirely and result in satisfactory long-term results.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Echocardiography, Doppler
  • Female
  • Heart Transplantation / adverse effects*
  • Hemodynamics / physiology
  • Humans
  • Male
  • Middle Aged
  • Pericardiectomy
  • Pericarditis, Constrictive / diagnostic imaging*
  • Pericarditis, Constrictive / etiology*
  • Pericarditis, Constrictive / surgery
  • Pericardium / diagnostic imaging
  • Pericardium / physiopathology
  • Pericardium / surgery
  • Treatment Outcome