Off-Pump Coronary Artery Bypass in a Patient with Congenital Absence of the Left Pericardium and an Extremely Left-Rotated Heart
DOI:
https://doi.org/10.1532/HSF98.20091114Abstract
Congenital anomalies of the pericardium are extremely rare and often difficult to diagnose. We describe a 66-year-old woman presenting with multivessel coronary artery disease and right heart insufficiency complicated by an extremely leftrotated heart due to a congenital absence of left pericardium. A multidetector row computerized tomographic study was performed to evaluate the torsion of the heart as well as the physical relationship between the left internal thoracic artery and the left coronary system. Off-pump coronary surgery was scheduled. Both the operative and postoperative courses were uneventful and the patient was discharged after 11 days.References
Brulotte S, Roy L, Larose E. 2007. Congenital absence of the pericardium presenting as acute myocardial necrosis. Can J Cardiol 23:909-12.nDias RR, Albuquerque JM, Pereira AC, et al. 2007. Holt-Oram syndrome presenting as agenesis of the left pericardium. Int J Cardiol 114:98-100.nFirstenberg M, Sai-Sudhakar CB, Raman SV, Michler RE. 2006. Technical considerations for myocardial revascularization in congenital bilateral hypoplasia of the pericardium. Ann Thorac Surg 81:352-4.nGatzoulis MA, Munk MD, Merchant N, Van Arsdell GS, McCrindle BW, Webb GD. 2000. Isolated congenital absence of the pericardium: clinical presentation, diagnosis, and management. Ann Thorac Surg 69:1209-15.nGersbach P, Kaufmann U, Althaus U. 1996. Congenital absence of the left pericardium with extreme intrathoracic displacement of the heart: case report and review of the literature. Eur J Cardiothorac Surg 10:473-6.nGoetz WA, Liebold A, Vogt F, Birnbaum DE. 2004. Tricuspid valve repair in a case with congenital absence of left thoracic pericardium. Eur J Cardiothorac Surg 26:848-9.nNguyen DQ, Wilson RF, Bolman RM 3rd, Park SJ. 2001. Congenital pericardial defect and concomitant coronary artery disease. Ann Thorac Surg 72:1371-3.nRashid A, Ahluwalia G, Griselli M, et al. 2008. Congenital partial absence of the left pericardium associated with tricuspid regurgitation. Ann Thorac Surg 85:645-7.nVan Son JA, Danielson GK, Schaff HV, Mullany CJ, Julsrud PR, Breen JF. 1993. Congenital partial and complete absence of the pericardium. Mayo Clin Proc 68:743-7.n
