Partial pericardial defect incidentally discovered during coronary bypass surgery.
Kuk Hui Son1, Ho Sung Son, Eun Jeong Choi
1Department of Thoracic and Cardiovascular Surgery, Korea University Medical School, Seoul, Korea.
Journal of Korean Medical Science
|January 7, 2010
Summary
A large pericardial defect was discovered and repaired in a patient with coronary artery disease. The defect impinged on coronary arteries, but surgical repair led to an uncomplicated recovery.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Pathology
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for treating three-vessel coronary artery disease.
- Pericardial defects are rare congenital or acquired abnormalities of the pericardium.
- Large pericardial defects can pose surgical challenges and risks.
Observation:
- A 71-year-old male patient with three-vessel coronary artery disease presented for CABG.
- Intraoperatively, a large pericardial defect (approx. 18 cm circumference) was identified at the cardiac apex.
- The defect's edge encroached upon epicardial coronary arteries, and the left phrenic nerve coursed along its boundary.
Findings:
- The patient successfully underwent coronary artery bypass grafting.
- The large pericardial defect was surgically repaired using a polytetrafluoroethylene (PTFE) patch.
- The surgical repair was technically successful without immediate complications.
Implications:
- This case highlights the importance of recognizing and managing large pericardial defects during cardiac surgery.
- Successful repair of large pericardial defects can prevent potential complications related to coronary artery impingement and phrenic nerve involvement.
- PTFE patch reconstruction offers a viable option for repairing significant pericardial defects, ensuring favorable patient outcomes.
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