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The Journal of Thoracic and... Jun 2018
Topics: Aortic Valve; Glutaral; Pericardium
PubMed: 29530579
DOI: 10.1016/j.jtcvs.2018.01.075 -
BMJ Case Reports Mar 2021A 59-year-old man presented with exertional dyspnoea and pretibial oedema that had lasted 6 months. He was referred to our hospital with suspected constrictive...
A 59-year-old man presented with exertional dyspnoea and pretibial oedema that had lasted 6 months. He was referred to our hospital with suspected constrictive pericarditis (CP). Several examinations, including CT, echocardiography and cardiac catheterisation, indicated heart failure associated with CP that had been induced by trauma 13 years prior. The CP and heart failure were unresponsive to medical treatment, therefore, a surgical pericardiectomy was performed, which is considered the only definitive treatment. Pathological examination of the resected pericardium revealed a fatty texture and dense fibrous connective tissues, which are associated with old haemorrhage and focal calcification. The patient's symptoms were improved to New York Heart Association Class I, and his peripheral oedema disappeared 6 months after leaving hospital.
Topics: Echocardiography; Heart Failure; Humans; Male; Middle Aged; Pericardiectomy; Pericarditis, Constrictive; Pericardium
PubMed: 33727294
DOI: 10.1136/bcr-2020-240235 -
Stem Cell Research Nov 2014From historical studies of developing chick hearts to recent advances in regenerative injury models, the epicardium has arisen as a key player in heart genesis and... (Review)
Review
From historical studies of developing chick hearts to recent advances in regenerative injury models, the epicardium has arisen as a key player in heart genesis and repair. The epicardium provides paracrine signals to nurture growth of the developing heart from mid-gestation, and epicardium-derived cells act as progenitors of numerous cardiac cell types. Interference with either process is terminal for heart development and embryogenesis. In adulthood, the dormant epicardium reinstates an embryonic gene programme in response to injury. Furthermore, injury-induced epicardial signalling is essential for heart regeneration in zebrafish. Given these critical roles in development, injury response and heart regeneration, the application of epicardial signals following adult heart injury could offer therapeutic strategies for the treatment of ischaemic heart disease and heart failure.
Topics: Animals; Heart; Humans; Myocardial Ischemia; Pericardium; Regeneration; Signal Transduction
PubMed: 24933704
DOI: 10.1016/j.scr.2014.04.007 -
Journal of the American College of... Dec 2020
Topics: Hospitalization; Humans; Morbidity; Pericarditis; Pericardium; Risk Factors
PubMed: 33243383
DOI: 10.1016/j.jacc.2020.10.018 -
Developmental Cell Mar 2020The epicardium is essential during cardiac development, homeostasis, and repair, and yet fundamental insights into its underlying cell biology, notably epicardium...
The epicardium is essential during cardiac development, homeostasis, and repair, and yet fundamental insights into its underlying cell biology, notably epicardium formation, lineage heterogeneity, and functional cross-talk with other cell types in the heart, are currently lacking. In this study, we investigated epicardial heterogeneity and the functional diversity of discrete epicardial subpopulations in the developing zebrafish heart. Single-cell RNA sequencing uncovered three epicardial subpopulations with specific genetic programs and distinctive spatial distribution. Perturbation of unique gene signatures uncovered specific functions associated with each subpopulation and established epicardial roles in cell adhesion, migration, and chemotaxis as a mechanism for recruitment of leukocytes into the heart. Understanding which mechanisms epicardial cells employ to establish a functional epicardium and how they communicate with other cardiovascular cell types during development will bring us closer to repairing cellular relationships that are disrupted during cardiovascular disease.
Topics: Animals; Cell Lineage; Gene Expression Regulation, Developmental; Pericardium; RNA-Seq; Single-Cell Analysis; Transcriptome; Zebrafish
PubMed: 32084358
DOI: 10.1016/j.devcel.2020.01.023 -
European Journal of Cardio-thoracic... Nov 2023Thick-patch pulmonary homograft, autologous pericardium and CardioCel Neo are common patch materials for aortic arch reconstruction. Insufficient data exist on sutured...
OBJECTIVES
Thick-patch pulmonary homograft, autologous pericardium and CardioCel Neo are common patch materials for aortic arch reconstruction. Insufficient data exist on sutured patch strength and limits of use. We evaluated failure strength of these materials to develop a failure prediction model for clinical guidance.
METHODS
Patch failure strength was evaluated via sutured uniaxial and burst pressure testing. In sutured uniaxial testing, patches were sutured to aortic or Dacron tabs and pulled to failure. In burst pressure testing, patches were sewn into porcine aortas or Dacron grafts and pressurized to failure. Failure membrane tension was calculated. A prediction model of membrane tension versus vessel diameter was generated to guide clinical patch selection.
RESULTS
Combining sutured uniaxial and burst pressure test data, pulmonary homograft failure strength {0.61 [interquartile range (IQR): 0.44, 0.78] N/mm, n = 21} was less than half that of autologous pericardium [2.22 (IQR: 1.65, 2.78) N/mm, n = 15] and CardioCel Neo [1.31 (IQR: 1.20, 1.42) N/mm, n = 20]. Pulmonary homograft burst pressure [245 (IQR: 202, 343) mmHg, n = 7] was significantly lower than autologous pericardium [863 (IQR: 802, 919) mmHg, n = 6] and CardioCel Neo [766 (IQR: 721, 833) mmHg, n = 6]. Our model predicts failure limits for each patch material and outlines safety margins for combinations of aortic diameter and pressure.
CONCLUSIONS
Sutured failure strength of thick-patch pulmonary homograft was significantly lower than autologous pericardium and CardioCel Neo. Patient selection (predicted postoperative arch diameter and haemodynamics) and blood pressure management must be considered when choosing patch material for arch reconstruction. In older children and adolescents, autologous or bovine pericardium may be more suitable materials for aortic patch augmentation to minimize the risk of postoperative patch failure.
Topics: Child; Humans; Animals; Cattle; Swine; Adolescent; Aorta, Thoracic; Polyethylene Terephthalates; Aorta; Blood Pressure; Hemodynamics; Pericardium; Retrospective Studies
PubMed: 37897688
DOI: 10.1093/ejcts/ezad366 -
Fertility and Sterility Mar 2021To present a five-step approach to the laparoscopic excision of pericardial and diaphragmatic endometriosis.
OBJECTIVE
To present a five-step approach to the laparoscopic excision of pericardial and diaphragmatic endometriosis.
DESIGN
Surgical video.
SETTING
Academic tertiary care hospital.
PATIENT(S)
35-year-old nulliparous woman observed for chronic pelvic pain and infertility with a diagnosis of diaphragmatic endometriosis at a prior laparoscopy. Symptoms included severe chest pain and right shoulder tip pain, refractory to multiple medical therapies.
INTERVENTION(S)
Laparoscopic excision of pericardial and diaphragmatic endometriosis.
MAIN OUTCOME MEASURE(S)
Description of the relevant anatomy, the literature surrounding pericardial and diaphragmatic endometriosis, and the approach to the surgical intervention and postoperative care.
RESULT(S)
The laparoscopic excision of the full-thickness pericardial and diaphragmatic endometriotic lesions was successfully completed according to five reproducible steps: upper abdominal survey, liver mobilization, excision of diaphragmatic endometriosis, intrathoracic laparoscopic exploration, and closure of the diaphragmatic defect.
CONCLUSION(S)
Although rare and challenging to diagnose and treat, pericardial and diaphragmatic endometriosis and its potentially debilitating symptoms can be successfully managed through a multidisciplinary and stepwise surgical intervention.
Topics: Adult; Diaphragm; Endometriosis; Female; Humans; Laparoscopy; Pelvic Pain; Pericardium; Video-Assisted Surgery
PubMed: 33272621
DOI: 10.1016/j.fertnstert.2020.09.152 -
JACC. Clinical Electrophysiology Dec 2021The pericardium of the human heart has received increased attention in recent times due to interest in the epicardial approach for cardiac interventions to treat cardiac... (Review)
Review
The pericardium of the human heart has received increased attention in recent times due to interest in the epicardial approach for cardiac interventions to treat cardiac arrhythmias refractory to conventional endocardial approaches. To support further clinical application of this technique, it is fundamental to appreciate the living anatomy of the pericardial space, as well as its relationships to the surrounding structures. The anatomy of the pericardial space, however, is extremely difficult regions to visualize. This is due to its complex 3-dimensionality, and the "potential" nature of the space, which becomes obvious only when there is collection of pericardial fluid. This potential space, which is bounded by the epicardium and pericardium, can now be visualized by special techniques as we now report, permitting appreciation of its living morphology. Current sources of knowledge are limited to the dissection images, surgical images, and/or illustrations, which are not necessarily precise or sufficient to provide relevant comprehensive anatomical knowledge to those undertaking the epicardial approach. The authors demonstrate, for the first time to their knowledge, the 3-dimensional living anatomy of the pericardial space relative to its surrounding structures. They also provide correlative anatomy of the left sternocostal triangle as a common site for subxiphoid access. The authors anticipate their report serving as a tool for education of imaging and interventional specialists.
Topics: Humans; Pericardium; Thorax
PubMed: 34949433
DOI: 10.1016/j.jacep.2021.09.008 -
JACC. Clinical Electrophysiology Jul 2020
Topics: Animals; Atrial Fibrillation; Catheter Ablation; Endocardium; Pericardium; Swine
PubMed: 32703567
DOI: 10.1016/j.jacep.2020.04.026 -
Multimedia Manual of Cardiothoracic... Nov 2021Replacements for diseased aortic valves are limited. Repair of the aortic valve is performed by only a few surgeons. A novel technique of aortic valve reconstruction...
Replacements for diseased aortic valves are limited. Repair of the aortic valve is performed by only a few surgeons. A novel technique of aortic valve reconstruction using autologous pericardium shows promising results. In this video tutorial, we demonstrate the Ozaki procedure using an ex vivo low fidelity simulation.
Topics: Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Humans; Pericardium; Replantation
PubMed: 34787966
DOI: 10.1510/mmcts.2021.075