RT Book, Section A1 Feins, Eric N. A1 Walker, Jennifer D. A2 Cohn, Lawrence H. A2 Adams, David H. SR Print(0) ID 1144167686 T1 Pericardial Disease T2 Cardiac Surgery in the Adult, 5e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071844871 LK accesssurgery.mhmedical.com/content.aspx?aid=1144167686 RD 2024/04/24 AB The pericardium envelops the heart and portions of the great vessels as a protective capsule. When incised longitudinally and transversely along the diaphragm it can be suspended to present the heart for surgical procedures. The surgical importance of the pericardium stems from its involvement in alterations of cardiac filling. When the limited space between the noncompliant pericardium and heart acutely fills with fluid, cardiac compression and tamponade may ensue. Constrictive disorders arise when inflammation and scarring cause the pericardium to shrink and densely adhere to the surface of the heart. This chapter discusses pericardial anatomy and function and describes the conditions that commonly give rise to the surgical problems of pericardial constriction and tamponade. The chapter also describes the diagnosis and therapy of these entities, the management of effusions and tamponade early and late after cardiac surgery, and the rationale for and against pericardial closure at the time of cardiac surgery.