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European Heart Journal 1989 10(7):670-675;
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Symptomatic congenital complete absence of the left pericardium. Case report and review of the literature

H. R. GEHLMANN and G. J. VAN INGEN

Onze Lieve Vrouwe Gasthuis, Amsterdam, Holland

Received 29 July 1988; revised 16 December 1988; .

Address for correspondence: H. R. Gehlmann MD, Koningin Julianalaan 15, 1421 AH Uithoorn, Holland

Abstract

A fully documented case of complete absence of the left pericardium in a 44-year-old male is presented. Complaints of acute chest pain were caused by strangulation of the heart between the pulmonary ligament and the diaphragm. Preoperative electrocardiogram, chest X-ray and echocardiography showed 'classic' signs as described in the literature. A CAT scan suggested absence of the left pericardium, the definitive diagnosis was made with the aid of thoracoscopy. This case of total absence of the left pericardium is the first documented one requiring thoracic surgery. The defect was closed through a left-lateral thoractomy using an allograft of pig pericardium.

Key Words: Left pericardium • surgical correction


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