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Circulation Aug 2008
Topics: Animals; Biomechanical Phenomena; Endocardium; Heart Ventricles; Myocardial Contraction; Myocytes, Cardiac; Pericardium; Sheep; Ventricular Function
PubMed: 18695201
DOI: 10.1161/CIRCULATIONAHA.108.797399 -
Surgery Today Jan 2015The objective of this study was to test the efficacy of an equine pericardial patch for repairing full-thickness defects of the stomach wall.
PURPOSES
The objective of this study was to test the efficacy of an equine pericardial patch for repairing full-thickness defects of the stomach wall.
METHODS
Circular defects, 1.5 cm in diameter, were created on the anterior wall of the stomach of 12 female New Zealand rabbits. The defects were repaired by an equine pericardial patch. After euthanasia at different time intervals (3 days to 8 weeks) a macroscopic evaluation of the abdominal cavity (including adhesion scoring), mechanical testing and a histological examination of the stomach were performed.
RESULTS
The animals survived the surgical procedure and underwent an uneventful recovery until euthanasia. None of the patches failed. Adhesions were observed in all animals and were significant in 3/12 animals. Bursting pressure testing indicated that the repair was durable and that adequate strength to prevent patch failure was achieved by the second week. A histological examination showed gradual narrowing of the perforation site by mucosal and limited muscular regeneration.
CONCLUSIONS
The equine pericardial patch was successfully used to repair a gastric defect in our experimental model, and it seems that it could have potential as a material suitable for further research concerning the repair of upper gastrointestinal defects.
Topics: Animals; Bioprosthesis; Digestive System Surgical Procedures; Disease Models, Animal; Female; Horses; Pericardium; Rabbits; Stomach; Tissue Scaffolds
PubMed: 25380578
DOI: 10.1007/s00595-014-1072-4 -
Medical Physics Aug 2021Epicardial fat is the adipose tissue between the serosal pericardial wall layer and the visceral layer. It is distributed mainly around the atrioventricular groove,...
PURPOSE
Epicardial fat is the adipose tissue between the serosal pericardial wall layer and the visceral layer. It is distributed mainly around the atrioventricular groove, atrial septum, ventricular septum and coronary arteries. Studies have shown that the density, thickness, volume and other characteristics of epicardial adipose tissue (EAT) are independently correlated with a variety of cardiovascular diseases. Given this association, the accurate determination of EAT volume is an essential aim of future research. Therefore, the purpose of this study was to establish a framework for fully automatic EAT segmentation and quantification in coronary computed tomography angiography (CCTA) scans.
METHODS
A set of 103 scans are randomly selected from our medical center. An automatic pipeline has been developed to segment and quantify the volume of EAT. First, a multi-slice deep neural network is used to simultaneously segment the pericardium in multiple adjacent slices. Then a deformable model is employed to reduce false positive and negative regions in the segmented binary pericardial images. Finally, the pericardium mask is used to define the region of interest (ROI) and the threshold method is utilized to extract the pixels ranging from -175 Hounsfield units (HU) to -15 HU for the segmentation of EAT.
RESULTS
The Dice indices of the pericardial segmentation using the proposed method with respect to the manual delineation results of two radiology experts were 97.1% 0.7% and 96.9% 0.6%, respectively. The inter-observer variability was also assessed, resulting in a Dice index of 97.0% 0.7%. For the EAT segmentation results, the Dice indices between the proposed method and the two radiology experts were 93.4% 1.5% and 93.3% 1.3%, respectively, and the same measurement between the experts themselves was 93.6% 1.9%. The Pearson's correlation coefficients between the EAT volumes computed from the results of the proposed method and the manual delineation by the two experts were 1.00 and 0.99 and the same coefficients between the experts was 0.99.
CONCLUSIONS
This work describes the development of a fully automatic EAT segmentation and quantification method from CCTA scans and the results compare favorably with the assessments of two independent experts. The proposed method is also packaged with a graphical user interface which can be found at https://github.com/MountainAndMorning/EATSeg.
Topics: Adipose Tissue; Computed Tomography Angiography; Coronary Artery Disease; Humans; Observer Variation; Pericardium; Tomography, X-Ray Computed
PubMed: 34062000
DOI: 10.1002/mp.15012 -
Herzschrittmachertherapie &... Jun 2022The arrhythmogenic substrate in patients with Chagas cardiomyopathy, arrhythmogenic dysplasia, postmyocarditis nonischemic dilative cardiomyopathy as well as after... (Review)
Review
The arrhythmogenic substrate in patients with Chagas cardiomyopathy, arrhythmogenic dysplasia, postmyocarditis nonischemic dilative cardiomyopathy as well as after extensive posterior or anterior wall myocardial infarction is predominantly located epicardially. This can necessitate epicardial access for an effective, substrate-based catheter ablation of the ventricular tachycardia (VT). Anterior percutaneous epicardial puncture represents the standard approach for epicardial VT ablation. The most important anatomical particularities that must be taken into account when performing an epicardial puncture or epicardial VT ablation are epicardial coronary arteries, left phrenic nerve and epicardial fat. The typical anatomic characteristics of the epicardial structures and resulting considerations for epicardial access are discussed here in detail.
Topics: Cardiomyopathies; Catheter Ablation; Humans; Pericardium; Phrenic Nerve; Tachycardia, Ventricular; Treatment Outcome
PubMed: 35556155
DOI: 10.1007/s00399-022-00856-w -
General Thoracic and Cardiovascular... Apr 2021Fissureless lobectomy of the lung is an operative technique in which hilar vessels and bronchus are divided before the interlobar fissure is separated. When hilar...
Fissureless lobectomy of the lung is an operative technique in which hilar vessels and bronchus are divided before the interlobar fissure is separated. When hilar vessels and bronchus cannot be exposed because of tumor progression, this procedure cannot be used. As an alternative, we propose here trans-pericardial fissureless left upper lobectomy, in which the left upper bronchus is exposed by dividing the posterior wall of the pericardium after the left upper pulmonary vein is divided in the pericardial cavity. This technique enables us to perform fissureless left upper lobectomy even when hilar vessels cannot be accessed outside the pericardium.
Topics: Bronchi; Humans; Lung; Lung Neoplasms; Pericardium; Pneumonectomy
PubMed: 33387331
DOI: 10.1007/s11748-020-01563-4 -
The American Journal of Medicine Aug 1993To determine the effectiveness of the preoperative evaluation and overall diagnostic efficacy of subxiphoid pericardial biopsy with fluid drainage in patients with new,...
PURPOSE
To determine the effectiveness of the preoperative evaluation and overall diagnostic efficacy of subxiphoid pericardial biopsy with fluid drainage in patients with new, large pericardial effusions.
DESIGN
A prospective interventional case series of consecutive patients admitted with new, large pericardial effusions.
PATIENTS AND METHODS
Fifty-seven of 75 consecutive patients admitted to a university tertiary-care center and a university-affiliated Veterans Administration Medical Center with new, large pericardial effusions were studied over a 20-month period. Each patient was assessed by a comprehensive preoperative evaluation followed by subxiphoid pericardiotomy. The patients' tissue and fluid samples were studied pathologically and cultured for aerobic and anaerobic bacteria, fungi, mycobacteria, mycoplasmas, and viruses.
RESULTS
A diagnosis was made in 53 (93%) patients. The principle diagnoses consisted of malignancy in 13 (23%) patients; viral infection in 8 (14%) patients; radiation-induced inflammation in 8 (14%) patients; collagen-vascular disease in 7 (12%) patients; and uremia in 7 (12%) patients. No diagnosis was made in four (7%) patients. A variety of unexpected organisms were cultured from either pericardial fluid or tissue: cytomegalovirus (three), Mycoplasma pneumoniae (two), herpes simplex virus (one), Mycobacterium avium-intracellulare (one), and Mycobacterium chelonei (one). The pericardial fluid yielded a diagnosis in 15 (26%) patients, 11 of whom had malignant effusions. The examination of pericardial tissue was useful in the diagnosis of 13 (23%) patients, 8 of whom had an infectious agent cultured. Of the 57 patients undergoing surgery, the combined diagnostic yield from both fluid and tissue was 19 patients (33%).
CONCLUSIONS
A systematic preoperative evaluation in conjunction with fluid and tissue analysis following subxiphoid pericardiotomy yields a diagnosis in the majority of patients with large pericardial effusions. This approach may also result in the culturing of "unusual" infectious organisms from pericardial tissue and fluid.
Topics: Biopsy; Follow-Up Studies; Humans; Pericardial Effusion; Pericardium; Preoperative Care; Prospective Studies
PubMed: 8356985
DOI: 10.1016/0002-9343(93)90262-n -
Cardiac Electrophysiology Clinics Jun 2020The optimal ablation strategy for non-paroxysmal atrial fibrillation remains controversial. Non-PV triggers have been shown to have a major arrhythmogenic role in these... (Review)
Review
The optimal ablation strategy for non-paroxysmal atrial fibrillation remains controversial. Non-PV triggers have been shown to have a major arrhythmogenic role in these patients. Common sources of non-PV triggers are: posterior wall, left atrial appendage, superior vena cava, coronary sinus, vein of Marshall, interatrial septum, crista terminalis/Eustachian ridge, and mitral and tricuspid valve annuli. These sites are targeted empirically in selected cases or if significant ectopy is noted (with or without a drug challenge), to improve outcomes in patients with non-paroxysmal atrial fibrillation. This article focuses on summarizing the current evidence and the approach to mapping and ablation of these frequent non-PV trigger sites.
Topics: Atrial Appendage; Atrial Fibrillation; Catheter Ablation; Coronary Sinus; Humans; Pericardium; Pulmonary Veins; Vena Cava, Superior
PubMed: 32451106
DOI: 10.1016/j.ccep.2020.01.002 -
In Vivo (Athens, Greece) 2021Left ventricular aneurysms are complications following acute myocardial infarction. Left posterior left ventricular aneurysms occurring in a submitral position...
BACKGROUND/AIM
Left ventricular aneurysms are complications following acute myocardial infarction. Left posterior left ventricular aneurysms occurring in a submitral position constitute a minor entity, and those leaving the mitral apparatus intact are extremely rare.
CASE REPORT
Herein, we report the case of a 58-year-old patient with a past medical history of coronary artery disease and myocardial infarction with a giant left posterior left ventricular aneurysm with moderate mitral valve incompetence.
RESULTS
The patient underwent myocardial revascularization and, through a transaneurysmal approach, successful endoventricular pericardial patch wall reconstruction with no impact on mitral valve competence.
CONCLUSION
Whenever the mitral valve is not affected, a trans aneurysmal approach with endoventricular pericardial patch in association with myocardial revascularization represents a safe and reproducible approach with good functional outcomes.
Topics: Heart Aneurysm; Heart Ventricles; Humans; Middle Aged; Mitral Valve; Myocardial Infarction; Pericardium
PubMed: 33910880
DOI: 10.21873/invivo.12455 -
The Annals of Thoracic Surgery Jun 2009We present a rare case of a pericardial hemangioma taking origin from the posterior wall of the left atrium and compressing the surrounding structures. Contrast cardiac...
We present a rare case of a pericardial hemangioma taking origin from the posterior wall of the left atrium and compressing the surrounding structures. Contrast cardiac magnetic resonance imaging preoperatively established the diagnosis, and computed tomographic findings helped in the management of this patient.
Topics: Aged; Heart Atria; Heart Neoplasms; Hemangioma; Humans; Male; Neoplasm Invasiveness; Pericardium
PubMed: 19463571
DOI: 10.1016/j.athoracsur.2009.03.005 -
The Journal of Thoracic and... Apr 1984The repair of many congenital heart anomalies would be facilitated by a tissue replacement for the atrial wall or pulmonary artery which would grow with the child. Such...
The repair of many congenital heart anomalies would be facilitated by a tissue replacement for the atrial wall or pulmonary artery which would grow with the child. Such a tissue has not previously been identified. In 12 puppies a broadly based flap of pericardium was sutured over the right atrial free wall. The atrial wall was excised from beneath the flap. In four animals the flap was then cut away from its pericardial attachments superiorly, inferiorly, and along the phrenic nerve, leaving an autogenous pericardial patch. In the other eight animals the flap was left intact, allowing retention of neural and vascular supply. The animals were put to death 263 +/- 23 days later. In four animals having a pericardial patch, the area of the patch did not increase (94% of original size, NS) despite an increase in body surface area (BSA) to 169% (p less than 0.05) of original BSA. In eight animals with a pericardial flap, the area of the flap increased to 214% (p less than 0.01) of the original size with an increase in BSA to 199% (p less than 0.01) of original BSA. The flap size index (size/BSA) increased to 109% of the original index while the patch size index decreased to 54% of the original, a significant difference (p less than 0.01). The broadly based pericardial flap grew in a manner parallel to BSA increase in these puppies.
Topics: Animals; Dogs; Heart Atria; Heart Defects, Congenital; Methods; Pericardium; Surgical Flaps
PubMed: 6708582
DOI: No ID Found