Microwave Device-Assisted Pericardiectomy for Immunoglobulin G4–Related Constrictive Pericarditis: A Case Report

Figures

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  Fig. 1. Preoperative imaging findings. (A) Preoperative CT image showing diffuse pericardial thickening. (B) Preoperative chest radiograph demonstrating cardiomegaly and clear lung fields. (C) Postoperative chest radiograph showing a reduced cardiac silhouette and no evidence of diaphragmatic elevation, suggesting absence of phrenic nerve injury.

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  Fig. 2. (A, B) The microwave device offered controlled, localized energy delivery, which may reduce the risk of stimulating arrhythmia and damaging adjacent neural structures such as the phrenic nerve. (C) Pericardiectomy, pericardiotomy, and epicardial crosshatching incision using the microwave device. (D) Effective use of a microwave ablation device for pericardial resection.

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  Fig. 3. Photomicrographs of the resected pericardium. (A) Hematoxylin and eosin staining showing fibrosis and chronic inflammation. (B) Storiform fibrosis increased the probability of IgG4-RD. (C) Immunostaining revealed numerous IgG4-positive plasma cells (IgG4/IgG ratio: 66%). IgG, immunoglobulin G; IgG4-RD, immunoglobulin G4-related disease