Pericardiectomy thickened pericardium

This picture demonstrates the appearance of pericardium from a constrictive pericarditis. Note that there is extensive adhesion of the pericardium to the heart; this picture is taken from the surgeons prospective on the right side of the table as the pericardium is elevated moving from the right side to the left side releasing the atrium first and then the ventricle. Notice the thickness of this is over ½cm and it is stiff and it sometimes will have calcium in the scar. The pericardium is generally removed from phrenic nerve to phrenic nerve and the heart is also freed up from the pericardium posteriorly to allow cardiac filling.