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-video">Video</span> <time class="date" datetime="2022-07-05" itemprop="datePublished">Published on July 5, 2022 </time> </p> <p data-module="share-links"> </p> </div> </div> </header> <div class="-padding--vertical -padding--horizontal"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__main"> <div class="layout-columns__main__content"> <div class="content-summary"> <h3 class="content-summary__heading">In This Video</h3> <ul> <li>In New England, there is a scarcity of pericardial disease clinics to care for patients with acute pericarditis, acute relapsing pericarditis or pericardial constriction</li> <li>Recurring pericarditis can be debilitating to patients and an operation to completely remove the pericardium may be necessary</li> <li>Thor Sundt, MD, co-director of the Corrigan Minehan Heart Center at Massachusetts General Hospital, explains how the center treats relapsing pericarditis and, in some cases, even cures the disease</li> </ul> </div> <div class="video-player" data-module="video-player" data-type="youtube"data-url="https://youtu.be/rxEKSQrXqLE" data-language='{"play":"Play video"}'> <a href="https://youtu.be/rxEKSQrXqLE"> </a> </div> <p><span>Recurring pericardial disease can be debilitating to patients, and an operation to completely remove the pericardium may be necessary. </span><a title="Research contributions Thor Sundt, MD" href="https://advances.massgeneral.org/contributors/contributor.aspx?id=1029">Thor Sundt, MD</a><span>, chief of the </span><a title="Division of Cardiac Surgery at Mass General" href="https://www.massgeneral.org/heart-center/treatments-and-services/cardiac-surgery">Division of Cardiac Surgery</a><span> and co-director of the </span><a title="Corrigan Minehan Heart Center" href="https://www.massgeneral.org/heart-center/">Corrigan Minehan Heart Center</a><span> at Massachusetts General Hospital, explains how the center treats relapsing pericarditis and, in some cases, even cures the disease.</span></p><div class="article__signup-container"> <div class="email-signup-inline__container -background--white"> <style> #email-signup-inline { /* 540px */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } @media only screen and (-webkit-min-device-pixel-ratio: 2), only screen and (min--moz-device-pixel-ratio: 2), only screen and (-moz-min-device-pixel-ratio: 2), only screen and (-o-min-device-pixel-ratio: 2/1), only screen and (min-device-pixel-ratio: 2), only screen and (min-resolution: 192dpi), only screen and (min-resolution: 2dppx) { #email-signup-inline { /* 1080 width */ background-image: url(/assets/raw/email-signup/cardiovascular-sub-callout.jpg); } } </style> <div class="content-container -width--wide -centered email-signup-inline__wrapper" id="email-signup-inline"> <div class="email-signup-inline__logo"> <img alt="Massachusetts General Hospital " src="/assets/logos/logo-white.svg"> </div> </div> <div class="email-signup-inline"> <h3 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pericarditis is clearly unpleasant, and uncomfortable—nobody wants to go through that. But recurrent relapsing pericarditis actually can be so debilitating to patients and simply by removing all the pericardium we can resolve their acute relapsing pericarditis. Now like all surgical procedures, it has to be done correctly and that means all of the pericardium needs to be removed. So you may have had experience with patients who had recurrent relapsing pericarditis, had a phrenic to phrenic pericardiectomy, and still had pain. That makes sense because there's a huge amount of pericardium behind the left phrenic nerve and on the diaphragm. So the right way to do this operation is to take all the pericardium, leave a little strip on the left phrenic nerve, but all the rest of the pericardium needs to go, and that's the way that you can treat acute recurrent relapsing pericarditis.</p> <p>In the same way as pericardial constriction, some subset of patients with acute pericarditis will develop constriction. There are lots of causes of this, most often it's idiopathic, and sometimes it's postsurgical. The most problematic group, of course, are the patients who have had previous mediastinal radiation, and the reason they are such a challenge is that they have a combination of pericardial constriction and restrictive cardiomyopathy because of the radiation damage to the heart itself.</p> <p>So particularly in patients with prior episodes of radiation you need a multidisciplinary team that includes a cardio-oncologist who really understands restrictive cardiomyopathy and can help us sort out how much of the patient's symptoms are constriction versus restriction. Most of the time that we're doing a pericardiectomy it's for constriction due to idiopathic causes, and in this case just like with acute relapsing pericarditis, one needs to be sure to take the entire pericardium in front and behind the phrenic nerve and off of the diaphragm. So you may have seen patients who were sent for pericardiectomy who didn't get relief… well, they may not have had a complete pericardiectomy. But if somebody has really got congestive failure from constriction from my standpoint it's a very gratifying condition to treat because we can actually cure it.</p> <p class="cta">Learn more about the <a href="https://www.massgeneral.org/heart-center/treatments-and-services/cardiac-surgery">Division of Cardiac Surgery</a></p> <p class="cta">Refer a patient to the <a href="https://www.massgeneral.org/heart-center/appointments-and-referrals/">Corrigan Minehan Heart Center</a></p> </div> </div> <aside class="layout-columns__sidebar -article__contributors"> <div class="layout-columns__sidebar__content"> <div class="profile-compact__wrapper"> <p class="u-no-margin"> <strong>Contributors</strong> </p> <div class="profile -compact" itemscope itemtype="http://schema.org/Person"> <div class="profile__content"> <h3 class="profile__name" itemprop="name"> <a href="/contributors/contributor.aspx?id=1029" itemprop="url">Thoralf M. Sundt, MD ›</a></h3><p class="profile__title" itemprop="jobTitle">Chief, Division of Cardiac Surgery, Co-Director, Corrigan Minehan Heart Center, Director, Cardiac Surgery Clinical Service, Mass General Brigham</p> </div> <p class="profile__image"> <img alt="Thoralf M. Sundt, MD" itemprop="image" srcset="/assets/images/contributors/Sundt_Thoralf_18899_advances.png, /assets/images/contributors/Sundt_Thoralf_18899_advances_2x.png 2x" src="/assets/images/contributors/Sundt_Thoralf_18899_advances.png"> </p> </div> </div> </div> </aside> <section class="topics-layout -article__related"> <div class="topics-layout__inner"> <div class="topics-layout__sidebar"> <h2 class="section-heading">Related topics</h2> </div> <div class="topics-layout__main"> <ul class="topics-list" data-module="topics-list"> <li><a href="/cardiovascular/topic.aspx?id=1036">Cardiac Surgery</a></li> </ul> </div> </div> </section> <section class="-padding--horizontal -padding--vertical -article__related"> <div class="layout-columns -width--wide -centered"> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/cardiovascular/journal.aspx?id=2218" itemprop="url">New-onset Late AF Is Uncommon After Surgical Aortic Valve Replacement</a> </h3> <p itemprop="description"> <p><span>The risk of late-onset atrial fibrillation after surgical aortic valve replacement is only 4%, according to a study by Thoralf M. Sundt, MD, Chin Siang Ong, MBBS, PhD, and colleagues. Prophylactic tissue ablation or ligation/amputation of the left atrial appendage may not be warranted at the time of surgery.</span></p></p> <p class="content-tease__related"> <a href="/cardiovascular/topic.aspx?id=1028" itemprop="relatedLink">Arrhythmia</a>, <a href="/cardiovascular/topic.aspx?id=1036" itemprop="relatedLink">Cardiac Surgery</a>, <a href="/cardiovascular/specialty.aspx?id=1002" itemprop="relatedLink">Cardiovascular</a>, <a href="/cardiovascular/topic.aspx?id=1012" itemprop="relatedLink">Valvular Heart Disease</a> </p> <p class="content-metadata"> <span class="content-metadata__media -journal">Journal</span> <time class="date" datetime="2022-05-09" itemprop="datePublished">May 9, 2022</time> </p> </div> </div> <div class="layout-columns__pod--half"> <div class="content-tease" itemscope itemtype="http://schema.org/ScholarlyArticle"> <p class="content-tease__topic"> <span class="highlight">Related</span> </p> <h3 class="content-tease__heading" itemprop="name"> <a href="/cardiovascular/video.aspx?id=1213" itemprop="url">The Heart Center & Responding to COVID-19</a> </h3> <p itemprop="description"> <p><span>The COVID-19 pandemic has caused an immense strain on health care institutions across the world. Thor Sundt, MD, discusses how the Division of Cardiac Surgery at Massachusetts General Hospital utilized a multidisciplinary approach to respond to the COVID-19 crisis.</span></p></p> <p class="content-tease__related"> <a href="/cardiovascular/topic.aspx?id=1036" itemprop="relatedLink">Cardiac Surgery</a>, <a href="/cardiovascular/specialty.aspx?id=1002" itemprop="relatedLink">Cardiovascular</a>, <a href="/research-and-innovation/topic.aspx?id=1056" itemprop="relatedLink">COVID-19</a> </p> <p class="content-metadata"> <span class="content-metadata__media -video">Video</span> <time class="date" datetime="2022-05-26" itemprop="datePublished">May 26, 2022</time> </p> </div> </div> </div> </section> </div> </div> </article> </div> </main>  <footer class="site-footer"> <div class="-padding--horizontal"> <nav aria-label="Footer links" class="content-container -width--wide -centered -padding--bottom"> <ul class="footer__nav" role="presentation"> <li> <a 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