J Korean Med Sci.  2010 Jan;25(1):145-147. 10.3346/jkms.2010.25.1.145.

Partial Pericardial Defect Incidentally Discovered During Coronary Bypass Surgery

• Son KH
• Son HS
• Choi EJ
• Sun K

• KMID: 1713846
• DOI: http://doi.org/10.3346/jkms.2010.25.1.145

Abstract

A 71-yr-old male patient with three vessel coronary artery disease underwent a coronary artery bypass graft. The patient was found to have a large pericardial defect at the apex of the heart that measured approximately 18 cm in circumference. The edge of the pericardial defect impinged on the epicardial coronary arteries. The left phrenic nerve descended via the dorsal boundary of the pericardial defect. Following coronary artery bypass grafting, the pericardial defect was repaired with a polytetrafluorethylene patch. The patient had an uncomplicated postoperative course.

Keyword

Congenital Abnormalities; Pericardium; Phrenic nerve; Coronary Artery Bypass

MeSH Terms

Aged
Coronary Angiography
*Coronary Artery Bypass
Coronary Artery Disease/radiography/*surgery
Humans
Male
Pericardium/*abnormalities
Phrenic Nerve
Polytetrafluoroethylene/therapeutic use
Polytetrafluoroethylene

Figure

• 

  Fig. 1 (A) Antero-posterior view of coronary angiography showing compression of the mid-left anterior descending artery (arrow). (B) Right antero-oblique view of coronary angiography showing stenosis of the proximal left circumflex artery (arrow).

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  Fig. 2 Schematic drawing depicting the intra-operative findings. As the heart herniated into the left pleural cavity, it was strangulated by the margins of the remaining pericardium, resulting in a bridle stricture of both the right and left margins of the heart, with subsequent narrowing of the ventricle in this area

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