Relapsing constrictive pericarditis after implantation of an expanded polytetrafluoroethylene surgical membrane

One of the challenges compounding the complexity of reoperative cardiac surgery are the surgical adhesions, which can be responsible for adverse intraoperative events. In such situations implantation of a substitute neo-pericardium has become a frequently used solution for avoiding injuries to the heart and great vessels, with rising numbers of reoperations. The pericardium can be reconstructed using biological (heterologous or autologous) or synthetic material, each having their pros and cons. In this report we present a case of relapsing constrictive pericarditis after implantation of expanded polytetrafluoroethylene neo-pericardium (GORE®). A highly differentiated algorithm and a careful preoperative review of indication is recommended in order to plan the optimal method of pericardioplasty, taking into account the pros and cons of each available material.

ECMO as a Bridge to Reoperative Cardiac Surgery in a Patient with Cardiogenic Shock and Severe Aortic Insufficiency Due to an Acute Aortic Valve Homograft Failure

We report a 62-year-old male who had severe aortic insufficiency after a homograft root replacement, requiring venoarterial extracorporeal membrane oxygenation prior to surgery due to profound cardiogenic shock. Severe aortic insufficiency is a contraindication for venoarterial extracorporeal membrane oxygenation, but we were able to stabilize the patient and successfully perform an urgent reoperative surgery.