The Waffle procedure for constrictive epicarditis after direct closure of atrial septal defect; report of a case
Suzuki, K.; Tsuboi, H.; Murakami, M.; Kobayashi, T.; Sirasawa, B.; Ito, H.; Mikamo, A.; Hamano, K.
Kyobu Geka. Japanese Journal of Thoracic Surgery 60(13): 1189-1191
2007
ISSN/ISBN: 0021-5252 PMID: 18078088 Document Number: 614660
A 20-year-old man was admitted with a diagnosis of constrictive pericarditis 6 months after direct closure of atrial septal defect (ASD). He complained of fatigue and dyspnea. Cardiac echo cardiography, computed tomography (CT), magnetic resonance imaging (MRI) and cardiac catheterization suggested pericardial and epicardial constriction. During the operation, the thickened pericardium was peeled off. Multiple longitudinal and transverse incisions were made in the thickened epicardium as reported by waffle. Postoperative hemodynamic state was improved. The cardiac index increased from 1.91 to 3.17 l/min/m2. The pulmonary capillary wedge pressure (PCWP) decreased from 26 to 14 mmHg, although dip and plateau pattern was maintained. The postoperative course was uneventful.