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

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

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 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

A 71-yr-old male patient with three vessel coronary artery disease underwent a coronary artery bypass graft. The patient was found to have a large pericardial defect at the apex of the heart that measured approximately 18 cm in circumference. The edge of the pericardial defect impinged on the epicardial coronary arteries. The left phrenic nerve descended via the dorsal boundary of the pericardial defect. Following coronary artery bypass grafting, the pericardial defect was repaired with a polytetrafluorethylene patch. The patient had an uncomplicated postoperative course.
Aged ; Coronary Angiography ; *Coronary Artery Bypass ; Coronary Artery Disease/radiography/*surgery ; Humans ; Male ; Pericardium/*abnormalities ; Phrenic Nerve ; Polytetrafluoroethylene/therapeutic use

Treatment of cardiac disease via the epicardium fell under the domain of cardiac surgery due to the need for an open thoracotomy. Since an open thoracotomy is invasive in nature and has the potential for complications, a minimally invasive and percutaneous approach would be more attractive for suitable patients. The recent success of epicardial ablation of refractory arrhythmia via the percutaneous pericardial approach has increased the potential for delivery of epicardial therapies. Epicardial ablation has increased the success and safety since anti-coagulation and transseptal catheterization for left atrial arrhythmias is not required. The pericardial space has also been used to deliver therapy for several cardiac diseases. There are reports on successful delivery of drugs and their efficacy. Even though there was a wide range of efficacies reported in those studies, the reported complication rates are strikingly low, which suggests that direct delivery of drugs to the epicardium via the pericardial space is safe. Furthermore, recent animal studies have supported the feasibility of epicardial delivery of biological agents, including genes, cells, and even genetically engineered tissue for therapeutic purposes. In conclusion, percutaneous pericardial cannulation of closed pericardial space can play a significant role in providing non-surgical therapy for cardiovascular diseases. However, it requires skills and operator experiences. Therefore, there is need to further develop new tools, safer techniques, and effective procedure environment before generalizing this procedure.
Animals ; Arrhythmias, Cardiac ; Biological Agents ; Cardiovascular Diseases ; Catheterization ; Catheters ; Drug Administration Routes ; Heart Diseases ; Humans ; Pericardium ; Thoracic Surgery ; Thoracotomy