Ultrasonic Wave Pericardiectomy for IgG4-Related Constrictive Pericarditis.

Ann Thorac Surg

Department of Cardiovascular Surgery, Kanazawa Medical Center, Kanazawa, Japan; Department of Clinical Laboratory Science, Kanazawa University, Kanazawa, Japan.

Published: November 2022

An 80-year-old woman presented with rare immunoglobulin G4 (IgG4)-related constrictive pericarditis. She underwent pericardiectomy, pericardiotomy, and crosshatching incision of the epicardium using an ultrasonic wave scalpel suitable for the feature of IgG4-related disease. Thereafter, her cardiac function improved remarkably. Additional corticosteroid therapy contributed to maintaining her healthy condition. Definitive diagnosis was based on novel organ-specific criteria. Herein, we highlight that the most important point in the pathological diagnosis of IgG4-related constrictive pericarditis is to determine the presence of IgG4-positive plasma cell infiltration and storiform fibrosis or obstructive phlebitis specific to chronic inflammation.

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http://dx.doi.org/10.1016/j.athoracsur.2021.12.065DOI Listing

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