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Ann Thorac Surg 2006;81:352-354
© 2006 The Society of Thoracic Surgeons

Case report

Technical Considerations for Myocardial Revascularization in Congenital Bilateral Hypoplasia of the Pericardium

Michael S. Firstenberg, MD, Chittoor B. Sai-Sudhakar, MBBS, Subha V. Raman, MD, Robert E. Michler, MD *

Department of Cardiothoracic Surgery, Ohio State University, Columbus, Ohio

Accepted for publication August 23, 2004.

* Address correspondence to Dr Michler, Department of Cardiothoracic Surgery, North Doan Hall, 8th Floor, Ohio State University, Columbus, OH 43210 (Email: msf5{at}po.cwru.edu).

Congenital hypoplasia of the pericardium is a rare clinical condition that is typically encountered as an incidental finding during routine thoracic imaging or cardiothoracic surgery. Chest pain symptoms, when they occur, are often initially attributed to coronary ischemic syndromes, but herniation of cardiac structures through the pericardial defect, ischemia from torsion of great vessels, or compression of pulmonary parenchyma through defects between the aortic and pulmonary arteries can occur. Careful attention to cannulation techniques, conduit length, and the aberrant course of the phrenic nerves, typically through pericardial fibrous bands, is critical to the successful conduct of cardiac surgery.






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