Congenital pericardial defects (CPDs) are infrequent anomalies that are usually asymptomatic and are discovered incidentally during unrelated interventions. Here we report the case of a CPD with herniation of an enlarged left atrial appendage identified during total thoracoscopic ablation (TTA) for persistent atrial fibrillation (AF). The persistent AF was successfully treated with a hybrid procedure, in which TTA was followed by an electrophysiological study.
Atrial Appendage* ; Atrial Fibrillation* ; Pericardium ; Thoracic Surgery, Video-Assisted

Pericardial cyst is an uncommon congenital mediastinal tumor. The majority of pericardial cysts are located in the right cardiophrenic angle, but rarely they can be located intrapericardially. We now present a case of a huge intrapericardial pericardial cyst excised with video-assisted thoracoscopic surgery.
Mediastinal Cyst ; Mediastinal Diseases ; Pericardium ; Thoracic Surgery, Video-Assisted

Adolescent ; Adult ; Echinococcosis ; surgery ; Female ; Humans ; Male ; Pericardium ; pathology ; surgery ; Young Adult

OBJECTIVETo explore and apply a reconstructive technique for thoracic and pericardial defects and cardiac exposure in a thoracoventropagus following the separation operation.

METHODSThe separation operation was performed by the abdominal, the cardiothoracic and the plastic reconstructive surgeons in three teams. Nonbiological material was used in infant A to reconstruct the defective his thorax and pericardium resulted from the separation surgery. During the operation, infant B was protected with emphasis, preserving larger amount of thoraco-abdominal tissue to facilitate one-stage repair by direct suturing. Multiple tongue-shaped large skin flaps were designed to repair the huge soft tissue defects. The wound was closed in one stage.

RESULTSBoth of the infants survived after the surgery. Infant A with severe defect of his anterior thorax and abdominal and consequent cardiac exposure was eventually cured in 3-year hospitalization.

CONCLUSIONThe repair and reconstruction of the defective tissues and organs in the thoraco-abdminal conjoined twins were highly difficult. The modern plastic surgical techniques used for the task were reliable, effective and successful.

Humans ; Infant ; Male ; Pericardium ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Suture Techniques ; Thoracic Wall ; surgery ; Twins, Conjoined ; surgery

BACKGROUND: Pericardial adhesion poses a major problem during re-operative cardiac surgery. The purpose of this study was to determine the effect of sodium carboxymethol cellulose on experimental pericardial adhesions. MATERIAL AND METHOD: Twenty-four rabbits were divided into 2 groups of 12 rabbits each and pericardial mesothelial injury was induced by abrasion. Group A included rabbits receiving intrapericardial injection of Ringer's solution, and Group B included rabbits receiving intrapericardial injection of 3% sodium carboxymethoyl cellulose solution. Three weeks after the surgery, the incidence of adhesions in Group A was compared with that in Group B. RESULT: Pericardial adhesions were evaluated by tenacity and type scores. Tenacity scores of 3 or greater were considered clinically significant adhesion. Pericardial adhesion was found in 100% of rabbits in group A. However 25% of the rabbits in Group B had pericardial adhesions(p<0.0001). Type scores were also considered clinically significant between 2 groups. CONCLUSION: Our findings demonstrated that intrapericardial injection of 3% sodium carboxymethyl cellulose solution reduced the incidence of pericardial adhesions in an animal models.
Carboxymethylcellulose Sodium* ; Cellulose ; Incidence ; Models, Animal ; Pericardium ; Rabbits ; Sodium* ; Thoracic Surgery

OBJECTIVETo explore the feasibility of bovine pericardium used as a material for guiding bone regeneration.

METHODS1 cm x 1 cm x 0.5 cm defects were created on both buccal sides of the mandibles of 11 dogs. One side was covered with Glutaraldehyde (GA) cross-linking bovine pericardium; no membrane covered side was used as control. The animals were sacrificed in 2 weeks, 4 weeks, 8 weeks and 16 weeks after operation to observe the repair of the bone defects.

RESULTS(1) Wounds healed well in 10 dogs. Meanwhile, wounds in dogs of 16 weeks group healed badly and severe inflammatory response was found in bovine pericardium treated area. (2) The pericardium can be maintained in vivo for 16 weeks without absorption, there were only mild inflammatory cells invading. (3) The bone defects covered with bovine pericardium repaired better than control groups significantly.

CONCLUSION(1) GA bovine pericardium have the effect on guiding bone regeneration in the repair of dog experimental bone defects and it is possible that the bovine pericardium will be used as a new kind of GBR material; (2) GA bovine pericardium has good biocompatibility.

Animals ; Biocompatible Materials ; Bone Regeneration ; physiology ; Cattle ; Dogs ; Feasibility Studies ; Male ; Mandibular Injuries ; surgery ; Pericardium ; physiology

A gastropericardial fistula, defined as penetration of a gastric lesion into the pericardium, is a rare occurrence. Such a fistula is usually associated with a huge ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of esophagogastric surgery, the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs), or Zollinger-Ellison syndrome. The patient in this case presented with shoulder pain and melena, caused by a gastropericardial fistula that had occurred as a late complication of postoperative esophagogastrostomy and a refractory gastric ulcer. Despite the severity of the condition, the patient showed great improvement after medical treatment and the fistula was cured at the end.
Esophagectomy/*methods ; Gastric Fistula/*diagnosis/*etiology ; Humans ; Male ; Middle Aged ; Pericardium/*pathology ; Stomach Ulcer/*complications/*surgery

A study was conducted to investigate the effectiveness of freeze-dried bovine pericardium (FDBP) as a biomaterial in diaphragmatic herniorrhapy in dogs. Eight adult dogs were randomly selected and divided into two equal groups. In FDBP group, a diaphragmatic defect was induced and repaired with an identical size of FDBP. In the control group, a diaphragmatic wall was incised at three-side border creating a flap and sutured. Grossly, only mild intrathoracic adhesion was observed for most of the animals, and no herniation occured. Microscopically, the biomaterial incorporated into the host's tissue by ingrowth of young muscle fiber and massive new blood vessel formation in between the fibrous tissue.
*Biological Dressings ; Biomechanics ; Diaphragm/pathology ; Diaphragm/surgery ; Freeze Drying ; Hernia, Diaphragmatic/pathology ; Hernia, Diaphragmatic/*surgery ; *Materials Testing ; Pericardium ; *Prostheses and Implants

BACKGROUND: Off-pump coronary artery bypass (OPCAB) patients often require fluid, vasopressor, or inotropic support.It is therefore important that vigilant monitoring be undertaken to guide intervention and monitor the effects of therapy.Continuous monitoring of cardiac output (CO) is advisable.The aim of this study was to compare continuous cardiac index (CCI) and stat cardiac index (SCI) with intermittent bolus cardiac index (ICI) in patients undergoing OPCAB surgery. METHODS: Matched sets of CI measurements among CCI, SCI, and ICI were collected in 35 patients undergoing elective OPCAB at specific time periods.Bland-Altman analysis was used to compare the agreement among the different methods. RESULTS: Bland-Altman analysis of CI measurements yielded a bias, precision, and percent error of 0.09 +/- 0.63 L/min/m(2) (46.2%) for CCI and 0.09 +/- 0.60 L/min/m(2) (44.0%) for SCI, compared with ICI measurements. CONCLUSIONS: We found that the agreement of CCI, SCI, and ICI was poor.This disagreement increased during periods of open thorax and open pericardium when compared to the period of closed thorax.Continuous CO measurements through pulmonary artery catheter should be interpreted with caution during OPCAB.
Bias (Epidemiology) ; Cardiac Output ; Catheters ; Coronary Artery Bypass, Off-Pump ; Humans ; Organothiophosphorus Compounds ; Pericardium ; Pulmonary Artery ; Thoracic Surgery ; Thorax

Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it's locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 cm at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.
Accidents, Traffic ; Adult ; Female ; Follow-Up Studies ; Humans ; Mediastinal Neoplasms ; Mediastinum* ; Pericardium ; Pleural Cavity ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy