[Constrictive pericarditis after minimally invasive coronary artery bypass grafting: report of a case].

Constrictive pericarditis (CP) after off-pump coronary bypass surgery, especially after minimally invasive direct coronary artery bypass (MIDCAB), had rarely been reported. We presened a surgically treated case of CP after MIDCAB via left anterior small thoracotomy. A 57-year-old man underwent MIDCAB with placement of an internal mammary artery to the left anterior descending coronary artery uneventfully. Four years after the operation, he began to experience exertional dyspnea. Computed tomography of the chest showed pericardial thickening. Cardiac catheterization revealed elevation and equalization of the pressures in the 4 chambers, as well as low cardiac output. Pericardiectomy using cardiopulmonary bypass through a median sternotomy was performed successfully without injury to the bypass graft. Postoperative hemodynamic measurements were improved. The patient has resumed normal activity and remained free from heart failure for over 5 years.