The pericardium is the sac that surrounds the heart and contains it in its own space. The pericardium serves to ensure that the heart is able to beat in a frictionless space, and guarantees the greatest freedom of movement for the individual cardiac chambers. Diseases of the pericardium are rare. Generally, they must be operated on as fluid accumulates in the pericardial sac, which in turn hinders cardiac output.
Thorascopic pericardial fenestration
Thoracoscopic pericardial fenestration is necessary if the heart and its performance is impeded by accumulated fluid in the pericardium. This happens especially in conjunction with malignant diseases, which can affect the pericardium and increase the production of liquid. In a thoracoscopic pericardial fenestration, a large hole is made in the pericardium with special instruments, allowing the fluid to drain into the chest cavity. This operation is often combined with a pleurodesis, which bonds the lungs to the pleura. This operation is generally performed thoracoscopically, and the hospital stay is usually less than a week.
Total resection of the pericardium (pericardiectomy)
The complete removal of the pericardial sac (pericardium) is required when the pericardium becomes fibrous due to chronic inflammation or irritation, and constricts the heart. In the past, it was primarily tuberculosis that infected the pericardium and limited cardiac output. In this operation, the entire pericardium is removed, allowing the heart to move freely and without restriction again. If the whole pericardium removed, it is not necessary to surgically construct a substitute sac. The heart is able to move freely between the lungs, without experiencing any technical problems. Nowadays, this operation is performed rarely, mainly because constrictive pericardial disease can be prevented through early treatment with medication.