Advanced effusive-constrictive pericarditis rescued by the aggressive waffle procedure

Gen Thorac Cardiovasc Surg. 2012 May;60(5):297-301. doi: 10.1007/s11748-011-0798-9. Epub 2012 Mar 28.


We report the case of a 68-year-old man with progressive heart failure due to effusive-constrictive pericarditis. During approximately 1 month, echocardiography revealed rapid progression from pericarditis with effusion without tamponade to pericardial thickening and diastolic dysfunction. Cardiac catheterization revealed that the pressure in the right heart chambers remained high after pericardiocentesis. The patient was rescued by aggressive pericardiectomy and sharp dissection of the epicardium into small fragments. This on-pump beating-heart surgery is known as the waffle procedure.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Catheterization
  • Cardiopulmonary Bypass*
  • Disease Progression
  • Echocardiography, Doppler
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Heart Failure / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pericardial Effusion / complications
  • Pericardial Effusion / diagnosis
  • Pericardial Effusion / surgery*
  • Pericardiectomy*
  • Pericardiocentesis
  • Pericarditis, Constrictive / complications
  • Pericarditis, Constrictive / diagnosis
  • Pericarditis, Constrictive / surgery*
  • Predictive Value of Tests
  • Tomography, X-Ray Computed
  • Treatment Outcome