Pericardiectomy
Encyclopedia
Pericardiectomy is the surgical removal of part or most of the pericardium
Pericardium
The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.-Layers:...

. This operation is most commonly done to relieve constrictive pericarditis
Constrictive pericarditis
In many cases, constrictive pericarditis is a late sequela, in other words a condition that is the consequence of a previous disease, of an inflammatory condition of the pericardium...

, or to remove a pericardium that is calcified and fibrous. There are many etiologies for constrictive pericarditis and it is better to know the exact cause as the post operative morbidity, mortality and life expectancy are strongly influenced by the cause.

It takes place by removing the infected, fibrosed, or otherwise damaged pericardium. The procedure begins when the surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 makes an incision in the skin over the breastbone and divides it to expose the pericardium. During the surgery, the surgeon will grasp the pericardium, cut the top of this fibrous covering of the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

, drop into the specimen bag, and the heart is recovered. Then, the surgeon will wire the breastbone back together, the incision is closed, and the procedure is completed.When all the portion of pericardium lying between the two phrenic nerves is excised it is called total pericardiectomy. In cases where total pericardiectomy is not possible, subtotal pericardiectomy is performed or, in extreme cases, a cruciate incision on the pericardium is performed.
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