History: The patient had chest tightness and shortness of breath with lower limb edema since 8 years ago, and the lower limb edema had worsened in recent January, and facial swelling was also present. He was referred to our hospital for consultation after being seen in an outside hospital and suspected of coronary artery disease. Special examination: X-ray chest radiograph: 61% cardiothoracic ratio, pericardial calcification, left pleural thickening (Figure 1). Chest CT: pericardial shell-like calcification and pleural effusion on both sides (Figure 2). Coronary angiography: no lesions in the coronary arteries. Surgery: a median incision was used. The surface of the heart was explored and the pericardium was extensively calcified (Figure 3). The right ventricular surface was dissected downward to the level of the normally pulsating myocardium, and at this anatomical level, it was separated to the left to the level of the left ventricular apex and left pulmonary vein; to the level of the diaphragm inferiorly; to the bifurcation of the pulmonary artery superiorly, cutting off the pulmonary artery narrowing loop; to the direction of the inferior vena cava, separating the narrowed portion; to the right to the level of the right pulmonary vein. The calcified pericardium was widely excised to remove the caseous necrotic tissue, and care was taken to protect the right and left phrenic nerves. The pericardial cavity was repeatedly flushed with saline. Postoperative course: The tracheal intubation was removed early in the morning of the first postoperative day, and the patient was transferred back to the general ward on the second day. Cardiotonic and diuretic treatment was routinely given. He was discharged on the 10th postoperative day. At the same time, combined anti-tuberculosis treatment with remifentan, rifampin and pyrazinamide was given. Figure 1: Figure 2: Figure 3.