Pericardial Fat Pad and Thoracic Aortic Surgery

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Pericardial Fat Pad and Thoracic Aortic Surgery G. Melissano, E. Civilini, P. Zannini, R. Chiesa EJVES Extra Volume 5, Issue 4, Pages 57-60 (April 2003) DOI: 10.1016/S1533-3167(03)00053-0

Fig. 1 Schematic drawing and intraoperative picture after graft substitution of a saccular aneurysm of the distal aortic arch. The suture lines lie over the oesophagus (1). Pericardial fat (2) is visible on the left side of the picture, its vascularization, which is depicted in the drawing, comes from the middle pericardial (3) and superior pericardial (4) branches of the internal thoracic artery (5). The phrenic nerve that runs together with the pericardiophrenic vessels (6) is identified and spared. EJVES Extra 2003 5, 57-60DOI: (10.1016/S1533-3167(03)00053-0)

Fig. 2 Schematic drawing and intraoperative picture after development of a pedicled pericardial fat pad and its mobilization around the graft between the oesophagus and the suture lines. EJVES Extra 2003 5, 57-60DOI: (10.1016/S1533-3167(03)00053-0)

Fig. 3 Schematic drawing and intraoperative picture after complete wrapping of the pericardial fat pad around the graft. The pad is secured with absorbable stitches. Its vascularization is checked before closing the chest. EJVES Extra 2003 5, 57-60DOI: (10.1016/S1533-3167(03)00053-0)