Off-pump pericardiectomy using an ultrasonic scalpel and a heart positioner.

The surgical treatment of constrictive pericarditis often requires extensive pericardial dissection under cardiopulmonary bypass. We performed a pericardiectomy in a patient with constrictive pericarditis without cardiopulmonary bypass, with assistance of a sternal retractor and a suction heart positioner. The severely calcified pericardium, which adhered tightly to the epicardium, was dissected with an ultrasonic scalpel. The operation was completed without blood transfusion. There was no malignant arrhythmia.