Effectiveness of the Waffle Procedure for Constrictive Pericarditis

: A 66-year-old woman was referred to our hospital with dyspnea. Right-sided congestive pleural effusion of an unknown etiology was detected and she was diagnosed with constrictive pericarditis. Pericardiectomy was performed via median sternotomy under extracorporeal circulation because severe adhesion was observed. However, hemodynamics did not improve after pericardial resection because of thickend epicardium in front of the right ventricle. Hence, the waffle procedure was additionally performed on the anterior surface of the right ventricle after coming-off the extracorporeal circulation. Although significant cardiac dilatation was achieved, hemodynamics did not change markedly. The symptoms gradually alleviated postoperatively and cardiac catheterization performed 3 weeks later revealed marked improvement in hemodynamics. Although improvement in hemodynamics takes time, the waffle procedure appears to be effective.