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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
PubMed

Insights

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.

Keywords:
Congenital AbnormalitiesCoronary Artery BypassPericardiumPhrenic nerve

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