Severely Calcified Pericardium: The Crown of Thorns
Jose Rubio-Alvarez, MD, PhD, Anxo Martinez de Alegria, MD, PhD,
Juan Sierra-Quiroga, MD, PhD, and Jose Manuel Martinez-Comendador, MD, PhD
Departments of Cardiac Surgery, and Radiology, University Hospital Santiago de Compostela, La Coruña, Spain
FEATURE ARTICLES
Fig 1.
Fig 2.
A
40-year-old woman was admitted for heart failure.
Echocardiography revealed a thickened and calcified pericardium. A chest radiograph showed pericardial calcification (Fig 1A). She did not report any
epidemiology or contact with tuberculosis. The patient
underwent surgery through a median sternotomy. At
surgery, a large quantity of calcium was observed in
the pericardium, mostly in the diaphragmatic surface,
atrioventricular grooves, and great arteries, but only
Address correspondence to Dr Rubio-Alvarez, University Hospital Santiago de Compostela, Framan-Bugallido 15866, La Coruña, Spain; e-mail:
[email protected].
© 2012 by The Society of Thoracic Surgeons
Published by Elsevier Inc
partial pericardiectomy was performed. No specific
cause was found after histopathologic examinations.
Postoperative multidetector computed cardiac tomography was performed, showing dense pericardial calcification
with infiltration into the anterior, diaphragmatic, and posterior wall of the heart (Fig 1B). A three-dimensional reconstruction of the myocardial calcification is shown in Figure
1C. A volume rendering of the heart showed dense pericardial calcification over the atrioventricular groove, diaphragmatic wall, and great arteries (Fig 2).
Multidetector computed cardiac tomography should
be a complementary technique in patients with pericarditis and extensive calcification, because it offers valuable
information for preoperative planning.
Ann Thorac Surg 2012;93:325 • 0003-4975/$36.00
doi:10.1016/j.athoracsur.2011.06.013
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