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PubMed1992

Congenital absence of pericardium as unusual cause of T wave abnormalities in a young athlete.

The congenital absence of pericardium is a rare condition which may determine electrocardiographic ST-T abnormalities. The case of a 16-year-old athlete who presented T-wave abnormalities at standard electrocardiogram performed during a physical checkup is reported. Ventricular repolarization tended to normalize during exercise and in right lateral decubitus. Chest x-ray and echocardiography showed typical signs of complete absence of the left pericardium. The definite diagnosis was made by computer tomography (CT) scan. The importance of a complete investigation of athletes with T-wave abnormalities is emphasized. Diagnostic and therapeutic features of the congenital absence of pericardium are discussed.

Adolescent↗
PubMed1999

Function of the normal pericardium.

Until recently, instrumenting the pericardium was possible only when a pericardial effusion is present or by surgical exposure of the pericardium. Techniques are now being developed to instrument the normal pericardium. This development will allow clinicians and investigators to study pericardial fluid in health and in a variety of disorders not associated with pericardial effusion. It will also be possible to improve our knowledge of pericardial pressure and the pericardial restraints on the heart.

Animals↗
PubMed1981

Biological and mechanical behavior of autologous pericardium used for tricuspid valvular replacement in dogs.

The fate of autologous pericardium when used to replace a tricuspid valve leaflet has been investigated in dogs. Changes have been studied by means of macroscopic, mechanical, histological, scanning electron microscopy, and in vitro culture techniques. In each of nine experiments the valve failed and death occurred within the first 15 post-operative days. Retraction, thickening of the cusp, fibrinous deposition and/or tissue rupture were associated with a decrease of resistance to traction tests, decrease of elasticity and increase of viscosity of the implanted tissue. The early behavior of autologous pericardium was characterized by precocious inflammatory reaction on the valve leaflets, focal disruption of the collagenous structure of the leaflets, absence of fibroblastic cell infiltration as confirmed by in vitro culture of implanted pericardium and the lack of endothelial-like cell surface at the 10th-15th postoperative day.

Animals↗
PubMed2001

Metastatic uterine papillary serous carcinoma to the pericardium.

BACKGROUND: Uterine papillary serous carcinoma is an aggressive tumor with a high propensity for distant spread. Metastases to the heart or pericardium are rare in gynecologic malignancies and usually fatal. CASE: A 64-year-old African American woman was diagnosed with recurrent uterine papillary serous carcinoma metastatic to the pericardium. Her case at presentation was significant for an elevated serum CA-125, evidence of metastatic disease to the liver, and massive cardiomegaly. Cytologic analysis of fluid obtained by pericardiocentesis confirmed recurrence. Despite treatment with paclitaxel and a pleuropericardial window, the patient succumbed to her disease. CONCLUSION: The prognosis for patients whose recurrent uterine papillary serous carcinoma has metastasized to the heart or pericardium is extremely poor. Effective adjuvant and salvage therapies are essential.

Cystadenocarcinoma, Papillary↗
PubMed1982

[Bovine pericardium - a new graft material for hernial repair (author's transl)].

We compared glutaraldehyde-fixed bovine pericardium with conventional Mersilene mesh with regard to suitability for repair of large incisional hernias in canine experiments. To test the materials the force needed to rupture them and the percentage of stretching to the breaking point were determined both in vitro and after implantation. The results showed that bovine pericardium is a suitable material for repair of large incisional hernias. Pericardium is superior to Mersilene mesh because of its minimal formation of adhesions with the underlaying bowel.

Animals↗
PubMed1978

A case report of surgical repair of traumatic rupture of the pericardium and diaphragm.

A 55 year-old male with traumatic rupture of the pericardium, diaphragm and spleen, and with crush of the pancreas was successfully operated upon. The diagnosis of rupture of the diaphragm was done on the chest X ray on admission, and the rupture of the pericardium was diagnosed at the time of laparotomy and thoracotomy. The ruptured spleen and the crushed pancreas tail were removed, and the ruptured pericardium and diaphragm were closed successively.

Accidents, Traffic↗
PubMed1998

[Pseudo-aneurysm of aortic arch and rupture into pericardium, a case report of successful surgical management].

This is a case report of 50 years old male suffering from pyrexia and epigastralgia 2 weeks prior to admission. On the 15th hospital day, he complained chest pain. Chest roentgenography revealed marked expansion of the mediastinum which was not existed upon admission. CT and MRI of the chest demonstrated a pseudoaneurysm of aortic arch at lesser curvature with extension into the pericardium. Exploration of the pericardium through median sternotomy disclosed fully filling with purulent effusion and blood clots. Following irrigation of the pericardial space and tube drainage, chest was closed. Repair of the aneurysm was postponded. Following continues irrigation of the pericardial space for 19 days, tube graft replacement of the aneurysm was performed under femorofemoral bypass and circuratory arrest through left thoracotomy. The aneurysmal space was filled with the omental pedicle to control infection. However, repeated bacteriological examination of the pericardium and aneurysm revealed no growth. Behçet disease was most suspected in report of the pathology.

Aneurysm, False↗
PubMed2000

Microphysiology of the pericardium: substrate for intrapericardial therapeutics.

Recent capability to enter the normal effusion-free pericardium has expanded intrapericardial therapy which was formerly restricted to patients with effusive pericardial disease, to intrapericardial treatment of cardiac diseases of all kinds. It is now possible to deposit in the intact pericardium a variety of therapeutic agents targeting the myocardium, valves, conduction system and even the endocardium. In addition to such specific agents, the unique microphysiology of the pericardial mesothelium provides investigators with 2 entirely new applications of intrapericardial therapy: 1. supplementing substances like prostanoids and a variety of immune factors, and 2. stimulating pericardial production of such products of metabolism, e.g., superfusion of the normal pericardium by non-steroidal antiinflammatory agents to stimulate prostanoid production with a variety of effects including possible inhibition of coronary thrombosis. Continuing research and development should determine the precise roles of these new applications in human medicine.

Cardiovascular Agents↗
PubMed2001

Lymphatic drainage of the pericardium to the mediastinal lymph nodes.

The lymphatic drainage of the pericardium may have a prognostic value in lung cancer and its anatomical pattern was the purpose of this study. The lymphatic vessels of the pericardium were visualized on 12 fresh adult human cadavers by injection of a green colorant by means of the classical equipment for pedal lymphography. Seventeen injections were performed on the right side and 22 injections on the left side, visualizing 20 and 29 lymphatic pathways respectively. Whatever the side injected, the lymphatic vessels mainly directed toward the tracheobronchial nodes (n = 35) and less frequently toward the prepericardial lymphatic vessels and nodes (n = 14). Such results demonstrate the aggravating role played by the lymphatic drainage in the prognosis of the lung cancers invading the pericardium.

Aged↗
PubMed1998

[Synovial sarcoma of the pericardium].

A precordial tumor of the pericardium was radiologically diagnosed as the cause of an untypical clinical picture of heart disease in a 41-year-old soldier. As the patient had an increased asbestos exposure due to his profession, he was admitted to operation under the tentative diagnosis of a pericardial mesothelioma and the question of an occupational disease (BK 4105). Microscopic and immunohistochemical findings are compatible with the diagnosis of a synovial sarcoma of the pericardium. The present immunohistochemical marker spectrum allowed a reliable differentiation between synovial sarcoma and pericardial mesothelioma, which is more frequent than synovial sarcoma. The epithelioid component was determined using the following antibodies: MNF 116, CK 19, CK 7, EMA and Ber EP-4 were positive while Factor VIII, Calretinin, S100, Vimentin, CEA, CD 31, bcl-2 and HBA-71 were negative. The sarcomatous component was determined with antibodies to Vimentin, bcl-2 and HBA-71 which were positive, and to MNF 116, CK 19, CK 7, Factor VIII, Calretinin, S100, EMA, CEA, Ber EP-4 and CD 31 which were negative. Synovial sarcomas of the pericardium in the lower anterior mediastinum or the myocardium are exceedingly rare. A causal relationship between tumor formation and an increased asbestos exposure--similar to the epidemiologically based experiences with pericardial mesothelioma--is not likely. Primary extrapericardial synovial sarcoma could be excluded.

Adult↗
PubMed2005

Congenital absence of the pericardium associated with congenital diaphragmatic hernia and hepatic hemangioendothelioma: case report and review of the literature.

An unusual case of a neonate with absent pericardium, left-sided diaphragmatic hernia, and hepatic hemangioendothelioma is described. The posterolateral diaphragmatic hernia was successfully repaired, and agenesis of the pericardium did not interfere with cardiac function postoperatively. The hepatic tumour was a coincidental radiological finding, while liver function and the biochemical profile were normal. We also present a review of the literature on congenital absence of the pericardium and conclude that all cases should be screened for cardiac and hepatic anomalies.

Hemangioendothelioma↗
PubMed2006

Extrapleural pneumonectomy via a lower door open thoracotomy with reconstruction of the diaphragm and pericardium using autologous materials for mesothelioma.

We performed extrapleural pneumonectomy (EPP) with combined resection of the diaphragm and pericardium via a lower door open (LDO) thoracotomy to treat right malignant pleural mesothelioma (MPM) in a 57-year-old man. Specifically, we extended the standard posterolateral thoracotomy skin incision along the anterior costal arch, and performed the thoracotomy by cutting into the 6th to 9th costal cartilage. The resulting defect of the diaphragm and pericardium were reconstructed with a reversed latissimus dorsi (LD) muscle flap and a fascia lata graft, respectively. The patient had an uneventful postoperative course without dyspnea or dysfunction of the extremities. The LDO thoracotomy provided a good operative field, especially for the costo- and cardiophrenic angles, allowing a complete resection of the diaphragm to be performed easily. Furthermore, the reversed LD muscle flap and fascia lata graft proved to be ideal autologous materials for reconstruction of both the diaphragm and the pericardium.

Diaphragm↗
PubMed1975

Thymoma masquerading as congenital partial absence of the left pericardium.

Interpretation of irregularities of the left heart border on routine posterior-anterior and lateral roentgenograms may be quite challenging. Partial absence of the left pericardium provides a characteristic abnormality of the left heart border. Described is a case of a thymoma which mimicked partial absence of the left pericardium on routine roentgenography. The importance of including both partial absence of the left pericardium and thymoma in the differential diagnosis of irregularities of the left heart border is discussed.

Adult↗
PubMed1983

Effect of the undisturbed pericardium on left ventricular size and performance during acute volume loading.

Studies in instrumental dogs have suggested that the pericardium alters left ventricular diastolic pressure-volume relations and thus may influence systolic performance. However, the instrumentation used in these studies disrupts the pericardium and may have influenced the results. We therefore studied five conscious dogs by methods not traumatic to the pericardium, before and after pericardiectomy. Although heart rate and left ventricular systolic and end-diastolic pressures were not different before or after pericardiectomy, either at rest or during volume loading, end-diastolic volume measured by biplane two-dimensional echocardiography increased post pericardiectomy at rest from 38 +/- 4 (SE) to 61 +/- 4 ml (p less than 0.05) and during volume loading from 68 +/- 5 to 79 +/- 5 ml (p less than 0.005). After pericardiectomy, ejection fraction was unchanged, but the peak value of the first derivative of left ventricular systolic pressure (dP/dt) increased significantly at rest from 17 +/- 2 to 26 +/- 4.0 x 10(2) mm Hg/sec. We conclude that pericardiectomy shifts the left ventricular end-diastolic pressure-volume curve to the right and increases the systolic isovolumic index of dP/dt in the basal state.

Animals↗
PubMed1982

A study of the effects of glutaraldehyde and formaldehyde on the mechanical behaviour of bovine pericardium.

The inherent variability in the mechanical behavior of bovine pericardium causes difficulties in establishing the effects of treatment procedures used in the manufacture of bioprosthetic cardiac valves. A new experimental technique has been developed in which the specimen acts as its own control, obviating the need to perform large numbers of experiments to obtain statistically significant results. The procedure used is described in detail as is the equipment employed. The technique was used to assess the effect of glutaraldehyde and formaldehyde on the stress/strain response of bovine pericardium. The results show that the fixing process in glutaraldehyde is virtually complete within two hours and causes significant changes in the mechanical behaviour of the tissue. The tissue becomes progressively stiffer as the treatment period is extended, which is especially pronounced at low levels of stress. Formaldehyde storage subsequent to fixing in glutaraldehyde was found to have no effect on the stress/strain response of the bovine pericardium.

Aldehydes↗
PubMed1994

Use of glutaraldehyde-gentamicin-treated bovine pericardium as a wound dressing.

Glutaraldehyde (GA)-pretreated gentamicin post-fixed bovine pericardium has been evaluated as a wound dressing in this study. Two excisions approximately 7 x 4 cm, each of full thickness skin, from the upper and lower parts down to, but not including, the panniculus carnosus were made from the back of the guinea pig. The skin excised from the upper part was placed on the wound bed of the lower part as an autograft, whereas the upper wound was closed using 5% sodium chloride-trypsin-0.1% GA-0.048% gentamicin-treated bovine pericardium and sutured for comparative study. The wounds were inspected every 3-6 d for infection and exudation. Histopathological studies were performed at weekly intervals in the post-operative period. At the fifth week, a very thin linear scar on the epidermal aspect without remarkable contracture was observed and histopathology showed the completion of epithelization across the wounds in all cases. This study demonstrates that GA-pretreated, gentamicin-post-fixed bovine pericardium may be used as an alternative biological dressing in the case of large wounds.

Animals↗
PubMed1987

Culture of mesothelial cells from bovine pericardium and characterization of their arachidonate metabolism.

Cultures of mesothelial cells from bovine pericardium were established and their arachidonate metabolism was characterized. The identification of the cultured cells was based on morphological observations, and by electrophoretic analysis of cytoskeletal proteins, which demonstrated a pattern previously reported for mesothelial cells. Factor VIII-related antigen was present by indirect immunofluorescence, but the cells had no thrombomodulin activity. The cultured pericardial cells metabolized arachidonic acid to 6-ketoprostaglandin F1 alpha and a small amount of prostaglandin E2. The same metabolites were produced by pieces of intact parietal pericardium but not by pieces from which mesothelium had been removed. The cultured mesothelial cells produced 94.6 +/- 60.4 (mean +/- S.D.) ng/mg (n = 3) cell protein of 6-ketoprostaglandin F1 alpha in response to the calcium ionophore A23187, 117.3 +/- 13.6 ng/mg (n = 3) with exogenous arachidonic acid, 18.3 +/- 11.3 ng/mg (n = 5) with bradykinin, 8.4 +/- 4.3 ng/kg (n = 4) with histamine and 11.2 +/- 9.7 ng/mg (n = 5) with thrombin. All of these values were significantly higher (P less than 0.05) than the control (2.1 +/- 1 ng/mg; n = 5). From these results, we conclude that the mesothelial cells account for the arachidonate metabolism in the pericardium. The production of prostaglandin I2 occurs in response to physiological or pathological, agonists, and is substantial. That is, it is approximately the same as endothelial cells. The release of eicosanoids by mesothelial cells into the pericardial space may have a significant role in cardiac physiology and pathology.

Animals↗
PubMed1994

The pericardium acts as a restricting factor on the release of ANF (1-98) and ANF (99-126) after volume loading in pigs.

The stimulus for secretion of the atrial peptides from the heart is a mechanical distension of the atria. We studied the changes in plasma levels of immunoreactive ANF (1-98) and ANF (99-126) after volume loading (NaCl 0.9%, 50 ml/kg in 10 min) in pigs that had their pericardium opened (peric-, n = 8) and compared these changes to those of pigs subjected to sham operation (peric+, n = 8). For irANF (99-126), the maximum increase was achieved 10 min after the start of loading: 18.6 +/- 5.5 pmol/l to 31.4 +/- 15.6 pmol/l. (P < 0.05) in peric+ and 23.9 +/- 6.5 pmol/l to 110.2 +/- 46.2 pmol/l (P < 0.05) in peric-. The maximum increase in irANF (1-98) took place after 15 min: 658.8 +/- 223.9 pmol/l to 791.0 +/- 229.4 pmol/l (P < 0.05) in peric+ and 769.9 +/- 228.5 pmol/l to 1136.7 +/- 348.6 pmol/l (P < 0.05) in peric-. For both peptides the maximal increase after loading was significantly greater when the pericardium had been removed. The results demonstrate that the intact pericardium restricts peptide release secondary to volume infusion in closed-chest pigs.

Animals↗