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Congenital pericardial defect

J C Funken1, Y d'Udekem d'Acoz, P Noirhomme

  • 1Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires St-Luc - UCL, 1200, Brussels, Belgium.

Cardiovascular Surgery (London, England)
|November 28, 2002
PubMed

Insights

A rare congenital pericardial defect caused a patient's heart to herniate into the chest. This case highlights the importance of considering congenital anomalies in cardiac surgery planning.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • A 72-year-old male underwent elective cardiac revascularization six weeks post-myocardial infarction.
  • Preoperative assessments, including physical examination and laboratory tests, revealed no abnormalities.
  • Coronary angiography indicated the patient was suitable for off-pump coronary artery bypass surgery.

Observation:

  • During the surgical procedure, the heart was observed to be completely herniated into the left thoracic cavity.
  • The herniated heart was positioned posterior to the phrenic nerve.

Findings:

  • The intraoperative finding suggests a significant congenital pericardial defect.
  • This anatomical anomaly likely predisposed the patient to cardiac herniation.

Implications:

  • Congenital pericardial defects, though rare, can present with significant clinical implications, including cardiac herniation.
  • This case underscores the necessity of thorough preoperative evaluation and awareness of congenital anomalies in cardiac surgical planning.
  • Reviewing the symptomatology and complications associated with congenital pericardial defects is crucial for improved patient outcomes.

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