case_images: PMC11164434_01
case_images: TC cardiaca demonstra espessamento e calcificacao pericardica e forma uma estrutura em anel transversal (A, setas); Compressao evidente da via de saida do ventriculo direito (B e C, setas); RM cardiaca mostrando pericardio espessado (D, seta); A ressonancia magnetica confirmou a estrutura do anel transversal (E, setas) e a via de saida do ventriculo direito comprimida (F, seta). VCS: veia cava superior; AP: arteria pulmonar; VD: ventriculo direito; VE: ventriculo esquerdo.
case_images: 0066-782X-abc-121-05-e20230576-gf01.jpg
case_images: PMC11164434_01_0066-782X-abc-121-05-e20230576-gf01.jpg
case_images: f1
case_images: Cardiac computed tomography (CT) was performed and demonstrated pericardial thickening and calcification ( Figure 1A and B , arrows), and obvious compression of the RVOT ( Figure 1B and C , arrows). The thickened tissue forms a transverse ring structure, which compresses the left and right ventricular base, resulting in cardiac cavity deformation ( Figure 1A , arrows). Cardiac magnetic resonance imaging (MRI) was also performed to assess whether it affected the myocardium, and the results suggested that the thickened pericardium, the transverse ring structure ( Figure 1D and E , arrows) compressed the RVOT ( Figure 1F , arrow).
case_images: Visao intraoperatoria da estrutura em "anel duplo vertical": a estrutura em anel transversal (A, seta); Corte da estrutura do anel mostrando a estrutura do anel sagital (B, seta); A imunohistoquimica no pos-operatorio confirma o diagnostico de pericardite constritiva com degeneracao hialina e calcificacao (C e D). VD: ventriculo direito.
case_images: 0066-782X-abc-121-05-e20230576-gf02.jpg
case_images: PMC11164434_01_0066-782X-abc-121-05-e20230576-gf02.jpg
case_images: f2
case_images: Intraoperative finding was that the "vertical double ring" structure is composed of the transverse ring at the root of the great artery and the sagittal ring along the atrioventricular sulcus, limiting the cardiac contraction, especially at RVOT and pulmonary artery ( Figure 2A and B ). The hemodynamics were stable during the operation, the cardiac cavity boundary was clear and active after the operation, the RVOT stenosis was significantly relieved ( Figure 2B ), and the central venous pressure decreased to 13mmHg. The removed specimens were examined pathologically and were noted to have no evidence of granulomatous inflammation, or acute inflammation, consisting solely of the thickened and fibrotic pericardium with calcifications ( Figure 2C and D ).
case_images: Radiografia de torax pos-operatoria (A), ultrassonografia cardiaca (B) e tomografia computadorizada (C) revelaram alivio da compressao da via de saida do ventriculo direito. VCS: veia cava superior; AP: arteria pulmonar.
case_images: 0066-782X-abc-121-05-e20230576-gf03.jpg
case_images: PMC11164434_01_0066-782X-abc-121-05-e20230576-gf03.jpg
case_images: f3
case_images: Postoperative follow-up revealed relief of RVOT compression ( Figure 3A - C ).