Eur J Cardiothorac Surg 2001;19:87-88
© 2001 Elsevier Science NL
Images in cardio-thoracic surgery |
Endomyocardial fibrosis of right ventricle
Fernando Hornero,
Maria J. Dalmau,
José A. Montero
Servicio de Cirugía Cardíaca, Hospital General Universitario de Valencia, Valencia, Spain
Received 17 August 2000;
received in revised form 18 October 2000;
accepted 18 October 2000.
Corresponding author. Tel.: +34-96-3862900; fax: +34-96-3862982
e-mail: fernando.hornero{at}hguv.org
A 58-year-old African man from Uganda was referred to our hospital for dysnea on exertion, ascites, splenomegaly, and peripheral edema. ECG revealed bradycardia with third-degree atrioventricular block. chest CT scan (Fig. 1) showed right ventricular thickening with calcifications, stenosis at outlet portion and obliteration of the apex, dilated atrium. Operative excision of the fibrotic endocardium was made with replacement of the tricuspid valve and implantation of pacemaker (Fig. 2). Microscopically, the involved endocardium demonstrates a thick layer of collagen tissue on top of a layer with calcifications. The patient was discharged after 9 days with substantial symptomatic improvement.
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Fig. 1. Chest CT scan showing endocardium right ventricular thickening with calcifications, dilated atrium.
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Fig. 2. Operative view of right ventricle through tricuspid valve. Endocardial calcific deposits and severe fibrosis extend from the inflow portion to the ventricle apex. The tricuspid valve is involved.
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