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Ultrasonic Wave Pericardiectomy for IgG4-Related Constrictive Pericarditis
Yasushi Matsumoto1, Satomi Kasashima2, Fuminori Kasashima2
1Department of Cardiovascular Surgery, Kanazawa Medical Center, Kanazawa, Japan.
Abstract:
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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