Fig. 1

Post-contrast T1-weighted cardiac MRI images. Preoperative MRI short-axis (a) and 2-, 3-, and 4-chamber long axis (b) delayed-enhanced inversion-recovery images demonstrate pericardial thickening and epicardial enhancement (arrows) with subtle periventricular septal flattening. On dynamic cine imaging and anatomic imaging (not shown) there is septal bounce during Valsalva suggesting ventricular inter-dependance and biatrial enlargement with dilated IVC and hepatic veins. These findings are absent on postoperative cardiac MRI (c-d)