title: [IgG4-related constrictive pericarditis treated by waffle procedure].
abstract: A 59-year-old man was admitted for evaluation of short of breath and bilateral leg edema that had progressively worsened over 3 months. Chest computed tomography revealed marked pericardial thickening. Cardiac echocardiography revealed right heart volume load and diastolic dysfunction. Cardiac catheterization revealed a dip-and-plateau pattern of the pressure curve of right ventricule (RV)without any coronary disease. On a diagnosis of heart failure due to pericardial constriction, he underwent pericardiectomy under cardiopulmonary bypass. Multiple longitudinal and transverse incisions like a waffle were made in the thickened epicardium and improved the hemodynamics. The symptoms improved after surgery. As serum level of immunoglobulin G(IgG)4 was elevated and IgG4-positive plasma cells were recognized in the resected pericardium, diagnosis of constrictive pericarditis of hyper-IgG4 disease was made.
authors: Division of Cardiovascular Surgery, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan.
authors: Yuichi
authors: Y
authors: Matsuzaki
authors: Yoshihiro
authors: Y
authors: Naruse
authors: Keita
authors: K
authors: Tanaka
authors: Aya
authors: A
authors: Tabata
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010494:Pericarditis, Constrictive / Q000276:immunology / Q000601:surgery*
chemical_list: D007074:Immunoglobulin G