The Significance of the Pericardium in Relation to Surgery of the Heart

I. Introduction. II. History. III. Experiments and Comment. 1. The effect of mechanical trauma applied to the pericardium. 2. The effect of blood in the pericardial cavity. 3. The effect of hot salt solution applied to the heart and to the pericardium. 4. The effect of infection in the pericardial cavity. 5. The effect of tincture of iodin injected into the pericardial cavity. 6. The transplantation of fat into defects of the pericardium. 7. Heart tamponade. Report of two cases. 8. The effect of pericardiectomy. IV. Summary. I. INTRODUCTION Following any surgical procedure on the heart, important and sometimes serious sequelae may arise which involve the pericardium or which may be dependent on its presence. The most important of these sequelae are (1) a rapidly forming pericardial effusion which may lead to fatal tamponade, and (2) cardiopericardial adhesions which commonly follow the subsidence of the effusion. The significance of these