CONGENITAL PARTIAL AND COMPLETE ABSENCE OF THE PERICARDIUM

Between 1952 and 1991, 15 Mayo patients were found to have partial or complete absence of the pericardium at the time of a cardiovascular su rgical procedure. One patient with complete absence of the left perica rdium had symptoms possibly related to the pericardial abnormality. Th is 42-year-old man had severe insufficiency of the tricuspid valve att ributable to chordal rupture of the anterior leaflet, possibly precipi tated by complete displacement of the heart into the left pleural spac e. Excision of the ruptured chordae and plication of the anterior flai l leaflet rendered a competent tricuspid valve. In two patients, a sma ll defect in the pericardium was repaired. Three patients who underwen t operation for complex congenital heart disease died: two early posto peratively and one late after a reoperation. In the other 12 patients, no early or late postoperative complications were encountered. Althou gh rare and usually asymptomatic, complete and partial deficiency of t he pericardium may lead to serious complications such as cardiac valvu lar insufficiency or incarceration of cardiac tissue.