Congenital Pericardial Defects Research Articles

Multimodality Imaging Approach Evaluation of the Congenital Pericardial Defect: a Contemporary Review.

This review presents the etiology, clinical manifestations, diagnostic approach, and treatment of congenital pericardial defects. It also highlights the critical role of echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance (CMR) in the diagnosis and management approach. Congenital pericardial defects are rare. Although most cases are found incidentally, some cases could potentially be associated with serious outcomes including sudden cardiac death. The diagnosis is often challenging due to non-specific clinical manifestations and electrocardiogram findings. Echocardiography is the first-line imaging investigation for the evaluation of this condition. Advanced cardiac imaging modalities, including CCT and CMR, play important adjuvant roles in establishing the diagnosis and assists with prognostication.

Left ventricular herniation and incarceration with infarction secondary to a pericardial defect in a dog

A 2-year-old spayed female Labrador Retriever with clinical signs of heart failure presented to necropsy with a pericardial defect with most of the left ventricle non-reducibly herniated into the pleural space. The herniated cardiac tissue was constricted by a ring of pericardium that allowed subsequent infarction, evidenced by a marked depression on the epicardial surface. A congenital defect was considered more likely than a traumatic cause, since the margin of the pericardial defect was smooth and fibrous. Histologically, the herniated myocardium was acutely infarcted while the epicardium at the defect margin was markedly compressed, including the coronary vessels. This appears to be the first report of ventricular cardiac herniation with incarceration and infarction (strangulation) in a dog. Similar cardiac strangulations may rarely occur in humans with congenital pericardial defects or acquired pericardial defects secondary to blunt trauma or thoracic surgery.

Case series, contemporary review and imaging guided diagnostic and management approach of congenital pericardial defects

ObjectiveCongenital pericardial defect (CPD) is a rare entity with an estimated frequency of 0.01%–0.04%. The recognition of this anomaly is important since it can be associated with serious complications. The...

Konjenital Parsiyel Sağ Perikardiyal Defekt

Congenital pericardial defects are rare and usually asymptomatic. These defects are detected incidentally during cardiac or thorax operations. Partial left pericardial defects are seen more frequently. On the contrary, partial right pericardial defects are seen very rarely. 59 year old male patient was operated for coronary artery bypass grafting. During the operation a partial right pericardial defect was detected. This defect was asymptomatic without creating a pressure. Therefore, we did not interfere with this defect. At the end of the surgery, right chest drain was inserted for this defect. Congenital pericardial defects are very rare and generally asymptomatic pathologies. The presence of these defects are difficult with conventional diagnostic methods. However, in some cases, these defects can create symptoms and lead to serious problems. The surgical treatment of this pathology is very simple. Due to its rarity and problem-free nature, these pathologies rarely come to mind. Therefore this condition may be a lethal and important pathology in some cases.

Fetal Death Resulting From an Isolated Congenital Partial Pericardial Defect

Congenital pericardial defects occur from a defect in the formation of the pleuropericardial membrane during embryonic development. This defect may be asymptomatic but can be fatal if complicated by herniation of any portion of the heart. We report two cases in which herniation of a portion of the heart occurred through a partial left pericardial defect and resulted in fetal death. In case one, there were no fetal symptoms, and in case two, an irregular heartbeat was detected prompting a fetal echocardiogram that was negative for heart abnormalities. Although isolated congenital pericardial defects are rare, they can result in fetal death. Awareness may help to refine ultrasonography or other diagnostic modalities to evaluate possible congenital pericardial defects in utero.

The Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Congenital Pericardial Defects

Pericardial defects are rare congenital anomalies that result from failure of the pericardium to form properly during embryogenesis. In this article, we present a case of a patient with persistent atrial fibrillation who underwent a multimodality imaging evaluation that included cardiac magnetic resonance imaging. Our patient demonstrated secondary signs of a partial defect that was not directly visualized on imaging and was ultimately diagnosed during open surgical intervention. This case illustrates that a high level of suspicion should be maintained for patients who demonstrate secondary imaging findings that suggest the presence of an underlying pericardial defect. Magnetic resonance imaging is the preferred modality for evaluating the pericardium, because of its ability to image the heart in any plane, improved soft tissue contrast compared with computed tomography, and lack of radiation exposure to the patient. However, direct visualization may be limited by patient-specific factors, such as paucity of pericardial fat and the size and location of the defect. In such cases, surgical evaluation may be necessary.

A Case of Partial Congenital Pericardial Defect Presenting as Acute Coronary Syndrome

Congenital pericardial defects are rare and asymptomatic for both partial and complete defects. However, some patients can experience syncope, arrhythmia, and chest pain. When a patient experiences a symptom, it may be caused by herniation and dynamic compression or torsion of a heart structure including the coronary arteries. Diagnosis of a congenital pericardial defect may be difficult, especially in old patients with concomitant coronary artery disease. The clinical importance of congenital pericardial defect has not been stressed and congenital pericardial defects are regarded as benign, but in this case, pericardial defect was responsible for myocardial ischemia. The authors report a case of partial congenital pericardial defect causing herniation and dynamic compression of the coronary arteries, presenting as an acute coronary syndrome in an old man, with an emphasis on the unique features of the coronary angiogram that support the diagnosis of partial pericardial defects.

Congenital pericardial defect with ruptured acute type A aortic dissection

We report 2 cases of congenital pericardial defect with ruptured acute type A aortic dissection. Case 1: An 83-year old man presented with sudden chest and back pain, and computed tomography (CT) showed acute aortic dissection with left pleural massive effusion. Because of his unstable haemodynamic condition with low blood pressure, an emergency operation was performed. We observed small amounts of bloody pericardial effusion, massive left-sided bloody pleural effusion and a partial left-sided pericardial defect of the pulmonary artery. The ascending aorta was replaced. The postoperative course was uneventful. Case 2: A 79-year old man presented with fainting followed by cardiac arrest and was resuscitated. Chest CT showed acute aortic dissection and massive haemothorax. Emergency operation was attempted, but was given up. We observed partial left-sided pericardial defect of the pulmonary artery. Further, we reviewed 6 cases of congenital pericardial defect with ruptured acute aortic dissection, including our 2 cases. In all the cases, the patients did not develop cardiac tamponade but had massive haemothorax due to congenital pericardial defects leading to confusion in diagnoses and surgical strategies. Therefore, it may be necessary to consider congenital pericardial defects before performing an operation in case of acute type A aortic dissection with massive haemothorax.

Left Ventricular Hernia in a Pediatric Transplant Recipient: Case Report and Review of the Literature

Cardiac hernias are rare occurrences resulting from congenital pericardial defects, trauma, or postsurgical changes. Difficult to diagnose, they can lead to significant morbidity and mortality. The first reported case of left ventricular herniation in a pediatric cardiac transplant recipient is presented, and the literature concerning diagnosis and management is reviewed. Clinicians must have a high index of suspicion to diagnose this rare and potentially lethal defect.

Congenital Partial Absence of the Left Pericardium Suspected on the Classical Chest X-ray

ongenital absence of the left pericardium is a rare phenomenon occurring as a result of abnormal embryologic development of the left cardinal vein which normally develops into the left pleuropericardial membrane. Congenital pericardial defects can occur alone or in association with other congenital anomalies. Although diagnosis with conventional imaging techniques is difficult to make, this condition can be identified through chest X-ray by: (1) levo-rotation of the heart with

Cardiac Herniation After Right Pneumonectomy

Cardiac herniation is a rare condition, which is often lethal in unrecognized cases. It is most commonly seen after pneumonectomy with associated pericardiotomy or pericardiectomy but has been reported in patients with iatrogenic, traumatic, and congenital pericardial defects. It is important that the radiologist be aware of this entity, as delay in diagnosis may be fatal. In this paper, we will discuss a case of cardiac herniation after right pneumonectomy and review the radiologic literature.

Giant pulmonary cyst associated with congenital pericardial defect

Congenital defects of the pericardium are rare. This report describes a young woman with a congenital complete pericardial defect who developed a giant pulmonary cyst. After operation the patient experienced chest pain caused by myocardial ischemia due to cardiac displacement. It is important to note that heart lability in patients with congenital pericardial defects may cause grave complications after thoracotomy associated with volume loss of the residual lung.

Congenital Pericardial Defect

A 72-yr-old man was electively admitted for cardiac revascularisation 6 weeks after an inaugural inferior infarct. His physical examination and laboratory test were unremarkable. According to his coronarography the patient was programmed for an off pump coronary artery bypass. During surgery the heart was found to be completely herniated in the left chest, passing on the posterior aspect of the phrenic nerve. Symptomatology and complications of congenital pericardial defects are reviewed.

Congenital pericardial defect

A 72-yr-old man was electively admitted for cardiac revascularisation 6 weeks after an inaugural inferior infarct. His physical examination and laboratory test were unremarkable. According to his coronarography the patient was programmed for an off pump coronary artery by-pass. During surgery the heart was found to be completely herniated in the left chest, passing on the posterior aspect of the phrenic nerve. Symptomatology and complications of congenital pericardial defects are reviewed.

Congenital pericardial defect and concomitant coronary artery disease

Chest pain is the most common presenting symptom among patients with congenital pericardial defects. A delay in diagnosis of a congenital pericardial defect occurred in a patient because he had concomitant atherosclerotic coronary artery disease. Multiple radiological studies had suggested the diagnosis. The pericardial defect caused myocardial ischemia by obstructing flow in three coronary arteries. Surgical repair of the pericardial defect along with coronary artery bypass grafting was performed to correct the problem.

Combined congenital pericardial and diaphragmatic defects: a case report

This report describes the case of a 62-year-old woman who had a preoperative diagnosis of mitral valve insufficiency. At operation her heart was covered by fat which was identified as omental tissue. The pathogenesis, clinical presentation and management of this disorder are presented.

Right congenital pericardial defects

Right congenital pericardial defects

Myocardial Rupture Presenting as Hemothorax Secondary to Congenital Pericardial Defect—A Case Report

A patient who sustained myocardial rupture following acute myocardial infarction is presented. The presenting sign was a left hemothorax. Surgical exploration confirmed myocardial rupture and a left-sided pericardial defect. The incidence of congenital pericardial defects and the presentation of myocar dial rupture is discussed.

Congenital pericardial defects.

AbstractA congenital partial defect of the left pericardium associated with a left diaphragmatic hernia and total myeloschisis in a stillborn dicephalus dibrachius triotus female monster is described. It is pointed out that the generally accepted view, viz., that pericardial defects result from either a failure of closure or incomplete closure of the pleuropericardial foramen, holds good only for the partial forms of the pericardial defects. It is proposed that complete defects of the pericardium are due to imperfect development of the pleuropericardial membrane, resulting in a rent, either medial or lateral to the phrenic nerve, through which the lung bud grows into the pericardial cavity. The hypothesis that imperfect development of the pleuropericardial membrane is due to a primary defect in the septum transversum is discussed. Rotation of the heart is proposed as an additional possible factor responsible for preponderance of left‐sided defects.

Congenital right-sided pericardial defect with herniation of part of the lung into the pericardial cavity

This study describes an infant with congenital right-sided pericardial defect and herniation of part of the lung into the pericardial cavity. The patient presented with severe heart failure caused by a ventricular septal defect, a patent ductus arteriosus and mitral stenosis. During periods of deterioriation severe signs of superior vena caval obstruction were present, thought to be due to pressure of the herniated part of the lung on this vein. Chest roentgenograms showed a clearly demarcated radiolucent shadow in the superior mediastinum. The infant died at age 8 weeks because of intractable congestive heart failure. Necropsy revealed, in addition to the cardiovascular malformations, aplasia of the vermis cerebelli. The embryologie aspects of congenital pericardial defects are discussed.