title: Technical considerations for myocardial revascularization in congenital bilateral hypoplasia of the pericardium.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Ohio State University, Columbus, Ohio 43210, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Firstenberg
authors.forename: Chittoor B
authors.initials: CB
authors.lastname: Sai-Sudhakar
authors.forename: Subha V
authors.initials: SV
authors.lastname: Raman
authors.forename: Robert E
authors.initials: RE
authors.lastname: Michler
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000209:etiology; D023921:Coronary Stenosis / Q000150:complications; D006321:Heart; D006801:Humans; D033162:Incidental Findings; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008323:Mammary Arteries / Q000601:surgery / Q000637:transplantation; D009024:Morphogenesis; D010496:Pericardium / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery; D010791:Phrenic Nerve / Q000002:abnormalities; D011183:Postoperative Complications / Q000517:prevention & control; D012133:Respiratory Paralysis / Q000517:prevention & control; D012399:Rotation; D020858:Tissue and Organ Harvesting / Q000379:methods