Pericardium: structure and function in health and disease

Abstract

Normal pericardium consists of an outer sac called fibrous pericardium and an inner one called serous pericardium. The two layers of serous pericardium: visceral and parietal are separated by the pericardial cavity, which contains 20 to 60 mL of the plasma ultrafiltrate. The pericardium acts as mechanical protection for the heart and big vessels, and a lubrication to reduce friction between the heart and the surrounding structures. A very important role in all aspects of pericardial functions is played by mesothelial cells. The mesothelial cells form a monolayer lining the serosal cavity and play an important role in antigen presentation, inflammation and tissue repair, coagulation and fibrinolysis. The two major types of mesothelial cells, flat or cuboid, differ substantially in their ultrastructure and, probably, functions. The latter display abundant microvilli, RER, Golgi dense bodies, membrane-bound vesicles and intracellular vacuoles containing electron-dense material described as dense bodies. The normal structure and functions of the pericardium determine correct healing after its injury as a result of surgery or microbial infection. The unfavorable resolution of acute or chronic pericarditis leads to the formation of adhesions between pericardial leaflets which may lead to serious complications.

Persistent fibrosis, hypertrophy and sarcomere disorganisation after endoscopy-guided heart resection in adult Xenopus

“…Given the important roles of the pericardium in cardiac function [55] it is probably not surprising that frog ventricles display marked signs of inflammation, even in the SHAM group.…”

Management of acute cardiac tamponade by direct autologous blood transfusion in interventional electrophysiology

“…Blood clotting may occur during AutoBT, but the incidence of procedure‐related thrombosis was very low, probably due to the high level of anticoagulation maintained during electrophysiological procedures. The fibrinolytic property of the pericardium may also reduce the risk of thrombosis during AutoBT . Nevertheless, no cases of AutoBT‐related infection, stroke, cognitive dysfunction or thrombotic events were observed.…”

Structure and Rheological Properties of Bovine Aortic Heart Valve and Pericardium Tissue: Implications in Bioprosthetic and Tissue-Engineered Heart Valves

“…Replacing the HVs with prosthetic HVs or cryopreserved homograft valves offers best solution for highly damaged HVs. However, short-term durability, limited supply of cryopreserved homografts, and continuous need of anticoagulation drugs are some of impediments for successful transplantation of bioprosthetic valves [33]. Furthermore, a series of surgeries are often required for replacing pediatric and young adult HVs as the implants often lack compatibility with host tissue in the form of mechanical properties leading to stunted growth.…”