Figure Legend
Figure 1: Marked thickening of pericardium (arrow)
Figure 2A: Demonstrating medial E’ velocity of 27.4cm/s, exceeding Mayo Clinic criteria of 9.0 cm/s for constrictive pericarditis
Figure 2B: The hepatic venous index of diastolic reversal velocity divided by systolic forward velocity equals 0.82 (NR = .78)
Figure 3: The pericardium was dense and fibrotic completely encapsulating the heart. At the beginning of the procedure, the central venous pressure (CVP) was 25mmHg. After the pericardium was incised to the level of the pericardial fat and removed the CVP was 15 mmHg.
Figure 4: Histopathologic examination revealed dense pericardial fibrosis with minimal microscopic calcification and epicardial neovascularization consistent with constrictive pericarditis.
Video 1: Transthoracic echocardiogram showing ventricular interdependence
Video 2: Cardiac MRI with evidence of septal bounce and pericardial thickening