Pericardial cyst resection

Pericardial cysts are also called pericardial cysts, pleural cysts, simple mediastinal cysts, serosal cysts. It consists of a single layer of endothelial cells or interstitial cells, containing a clear liquid in a single room or a few multi-atrial cysts. It is connected to the pericardium, and most of them are in the right heart. The difference between a pericardial cyst and a pericardial diverticulum is that the former is not connected to the pericardial cavity, and the latter is in communication with the pericardial cavity. Pericardial cysts can be seen in the chest X-ray examination with clear boundaries, smooth edges, uniform density of round or oval masses, mostly in the palpebral horn. The shape of the block visible under fluoroscopy varies with body position. Echocardiography can reveal a liquid dark area at the palpebral angle. Treating diseases: pericardial cysts Indication Pericardial cystectomy is applicable to: 1. The nature of the chest mass is difficult to determine. 2. Giant pericardial cysts compress the heart and lungs, causing heart and lung function. 3. Pericardial cysts break into the bronchial or pleural cavity. 4. Pericardial cysts complicated by infection. Contraindications 1. Hemorrhagic disease, severe thrombocytopenia and those who are receiving anticoagulation are relatively contraindicated. 2. Those who intend to puncture the site with infection or bacteremia or sepsis. 3. Patients who do not work well with the surgical procedure. Preoperative preparation General anesthesia, endotracheal intubation to maintain breathing. The position depends on the surgical path. In view of the fact that most of the congenital pericardial cysts are located in the right ventricle, the cyst can be removed through the right thoracic incision. Take the supine position, the right chest pad is 30°-40° high, and the right forearm is fixed on the head frame. Surgical procedure 1. Incision: The fourth intercostal space of the right thoracic incision into the chest. 2. After entering the chest, extracardiac exploration to determine the location and size of the pericardial cyst. Most pericardial cysts and the pericardium are loosely adhered. The vasospasm can be used to gently clamp the wall of the capsule and sharply separate, and the cyst can be completely removed. 3. If the cyst is infected, the cyst wall and the surrounding tissue often have dense adhesion. It is difficult to completely remove the cyst. The cyst wall can be cut open, the cyst fluid can be absorbed, and the cyst wall can be rubbed with iodine and ethanol to prevent infection spread. Then, the capsule wall is removed in pieces. In the case of dense adhesion, if the resection is difficult, the remaining cyst wall edge can be fixed on the chest wall incision, and the capsule internal tube is drained until it gradually heals.

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