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A safe, rapid method for estimating left ventricular volume in man during the course of hemodynamic studies should prove helpful in the assessment of cardiac disease and useful in physiological research. It is the purpose of this report to present left ventricular volume measurements in man that were obtained by an indicator dilution method which employs cold as the indicator. This circulatory indicator has been studied by several workers (1-4) and has been used for left ventricular volume determinations in animals previously (5-10). The method employed was adapted from those used by Rapaport and his co-workers for left ventricular volume measurements in the dog (7) and right ventricular studies in man (11).

Fourteen patients underwent right heart catheterization 5 to 86 months after pericardiectomy for constrictive pericarditis. Twelve had preoperative catheterizations, all with findings typical of constrictive pericarditis. All patients showed marked hemodynamic and symptomatic improvement after operation. Three patients had persistent mild elevation of right heart and pulmonary artery pressures; one of these had a low cardiac output. Two other patients developed pulmonary hypertension with exercise, and one man showed an inadequate increase in cardiac output with exercise. Twelve patients were asymptomatic postoperatively and two had exertional dyspnea. Patients with incomplete pericardiectomy over the ventricles had abnormal hemodynamic results, while decortication of the atria and venae cavae made no difference in the postoperative findings. A left anterolateral thoracotomy incision provided adequate exposure for pericardiectomy, and continues to be the incision of choice at this hospital. Younger patients and those who progressed from recognized acute pericarditis to pericardial constriction more frequently had normal results at cardiac catheterization after operation. Certain preoperative liver-function tests correlated well with the postoperative hemodynamic findings. The role of myocardial disease in producing residual hemodynamic abnormalities remains unresolved. It is concluded that excellent clinical results and normal hemodynamic findings can be achieved by pericardiectomy in most patients with constrictive pericarditis.