Constrictive Pericarditis Post-Lung Transplant

Abstract

Constrictive pericarditis is a rare entity following lung transplant, with only seven previous cases reported in the literature. We present two additional cases and review the literature on this subject. Constrictive pericarditis should be considered in lung transplant patients who present with dyspnea and evidence of cardiac failure. Pericardiectomy remains the treatment of choice irrespective of the etiology.

Constrictive Pericarditis After Lung Transplantation

“…Constrictive pericarditis following LTx results from progressive pericardial inflammation and fibrosis, which leads to diastolic dysfunction and reduced cardiac output and occurs at a rate of 0.4% to 0.8% ( 2 , 4 , 6 ). Recommended therapy is complete surgical pericardiectomy, and post-pericardiectomy prognosis depends on cause of constriction ( 4 ).…”

“…Elevated jugular venous pressure without left cardiac disease or pulmonary hypertension raises suspicion for constrictive pericarditis, an infrequent complication with estimated incidence of 0.4% in patients following LTx ( 1 ). Since the late 1980s, there have been 20 reported cases of post-LTx cardiac constriction ( Table 1 ) ( 1 , 2 , 3 , 4 , 5 , 6 ). It is challenging to differentiate post-surgical cardiac septal wall motion and post-operative respirophasic variation from significant constrictive physiology ( 7 ).…”