Cardiac transplantation for cardiomyopathy with constrictive pericarditis

Constrictive pericarditis is a great mimic and has posed a diagnostic dilemma since its first description 300 years ago as “Concretio Cordis.” It can mimic restrictive cardiomyopathy, endomyocardial fibrosis, and chronic liver and renal disease. This would perhaps be the first clinical report of constriction in patients undergoing cardiac transplantation. We report two distinct cases with cardiomyopathy requiring cardiac transplantation and the clinical implications of concomitant pericardial constriction. While the first case mimics a natural “cardiac support device,” which addresses ventricular remodeling in heart failure by reducing the wall stress, the second case is a case in point against the use of “biological pericardial membrane—like the bovine pericardium,” as a pericardial substitute.