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Pericardiectomy is the surgical removal of part or most of the pericardium. [1] [2] This operation is most commonly used to relieve constrictive pericarditis, or to remove a pericardium that is calcified and fibrous. [2] It may also be used for severe or recurrent cases of pericardial effusion. [3]
The pericardium is a fibrous sac surrounding the heart composed of two layers: an inner visceral pericardium and an outer parietal pericardium. [1] The area between these two layers is known as the pericardial space and normally contains 15 to 50 mL of serous fluid. [2]
Constrictive pericarditis is a condition characterized by a thickened, fibrotic pericardium, limiting the heart's ability to function normally. [1] In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause.
A catheter is often left in the pericardium to continue draining any remaining fluid after the initial procedure. [7] The catheter can be removed when the hemopericardium no longer persists. The underlying causes of the condition, such as over-prescription of anticoagulants , must be addressed as well so that the hemopericardium does not return.
Pulmonary artery agenesis refers to a rare congenital absence of pulmonary artery due to a malformation in the sixth aortic arch. It can occur bilaterally, with both left and right pulmonary arteries being absent, or unilaterally, the absence of either left or right pulmonary artery (UAPA).
CPB is needed to divert blood from the heart and lungs and supply the body with oxygen and blood while the pulmonary vasculature is operated on. Cardioplegia is initiated as the approach to the pulmonary arteries is performed through the pericardium, a fibrous sac surrounding the heart.
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The typical signs of post-pericardiotomy syndrome include fever, pleuritis (with possible pleural effusion), pericarditis (with possible pericardial effusion), occasional but rare pulmonary infiltrates, and fatigue. [1] [2] Cough, pleuritic or retrosternal chest pain, joint pain and decreased oxygen saturation can also be seen in some cases. [1]