Abstract
Chronic pericarditis (CP) with bony encasement of the heart resulting in constrictive pathophysiology is relatively rare. We report a 43-year-old female with CP and long-standing right heart failure in New York Heart Association (NYHA) Class IV while on medical management, who was subsequently referred for surgery. Patient had porcelain bony encasement of the heart which was safely resected with the aid of cardiopulmonary bypass (CPB). There was a dramatic reduction in the central venous pressure and subsequent improvement in functional status to NYHA Class I–II postoperatively. While pericardiectomy is generally performed without CPB, it may be a useful adjunct in patients with heavily calcified porcelain pericardium. CPB facilitates more complete pericardial resection leading to lower incidence of residual constrictive symptoms postoperatively in patients with porcelain CP. Although there was no histologic or bacteriologic evidence of tuberculosis (TB), the presumptive etiology was TB given its prevalence in our environment.
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