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The '''pericardial sinuses''' are impressions in the [[Pericardium|pericardial sac]] formed between the points where [[great vessels]] enter it.{{Infobox anatomy
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{{Infobox Anatomy |
Name = Pericardial sinus |
| Name = Pericardial sinus
Latin = |
| Latin =
| Image = Gray489.png
GraySubject = 137 |
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| Caption = Posterior wall of the pericardial sac, showing the lines of reflection of the serous [[pericardium]] on the [[great vessels]]. (Transverse sinus labeled at center. Oblique sinus not labeled, but visible inferior to transverse sinus between the right and left [[pulmonary vein]]s)
GrayPage = 526 |
Image = Gray489.png |
| Image2 =
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| Caption2 =
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Caption = Posterior wall of the pericardial sac, showing the lines of reflection of the serous [[pericardium]] on the [[great vessels]]. (Transverse sinus labeled at center. Oblique sinus not labeled, but visible below transverse sinus between the right and left [[pulmonary vein]]s) |
Image2 = |
| System =
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Caption2 = |
System = |
MeshName = |
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DorlandsID = |
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There are two '''Pericardial sinuses''': transverse and oblique.


== Structure ==
* The cul-de-sac enclosed between the limbs of the inverted U of the venous mesocardium lies behind the [[left atrium]] and is known as the '''oblique sinus'''. .
There are three pericardial sinuses: superior, transverse and oblique.<ref name=":0">{{Citation|last=Issa|first=Ziad F.|title=27 - Epicardial Ventricular Tachycardia|date=2019-01-01|url=http://www.sciencedirect.com/science/article/pii/B978032352356100027X|work=Clinical Arrhythmology and Electrophysiology (Third Edition)|pages=907–924|editor-last=Issa|editor-first=Ziad F.|place=Philadelphia|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-52356-1.00027-x|isbn=978-0-323-52356-1|access-date=2020-11-16|last2=Miller|first2=John M.|last3=Zipes|first3=Douglas P.|editor2-last=Miller|editor2-first=John M.|editor3-last=Zipes|editor3-first=Douglas P.}}</ref>


* The '''superior''' '''sinus''' is anterior to the [[ascending aorta]] and the [[Pulmonary artery|pulmonary trunk]].<ref name=":0" /> It cannot be assessed in [[electrophysiology]] procedures.<ref name=":0" />
* The passage between the venous and arterial mesocardia—i.e., between the [[aorta]] and [[pulmonary artery]] in front and the superior vena cava behind—is termed the '''transverse sinus'''.<ref>{{DorlandsDict|nine/000957022|transverse sinus}}</ref> Also, the sinus that forms in the pericardial cavity where the dorso-mesentary pericardium reside.

* Can be used to pass ligature during cardiac surgery.
* The '''oblique sinus''' is an inverted [[Glossary of shapes with metaphorical names|J-shaped]] reflection of the [[venae cavae]] and [[Pulmonary vein|pulmonary veins]].<ref name=":1">{{Citation|last=Klick|first=John C.|title=23 - Echocardiographic Evaluation of Pericardial Disease|date=2014-01-01|url=http://www.sciencedirect.com/science/article/pii/B9781455707614000232|work=Perioperative Transesophageal Echocardiography|pages=253–264|editor-last=Reich|editor-first=David L.|place=Philadelphia|publisher=W.B. Saunders|language=en|doi=10.1016/b978-1-4557-0761-4.00023-2|isbn=978-1-4557-0761-4|access-date=2020-11-16|last2=Ali|first2=Jafer|last3=Avery|first3=Edwin G.|editor2-last=Fischer|editor2-first=Gregory W.}}</ref> It lies behind the [[Atrium (heart)|atria]] (particularly the [[left atrium]]),<ref name=":0" /> and in between left and right pulmonary veins.
* The '''transverse sinus''' is the tunnel-shaped passage posterior to the [[aorta]] and [[pulmonary trunk]] , and anterior to the [[superior vena cava]].<ref name=":0" /><ref name=":1" /> This sinus is clinically important because passing one end of clamp through the sinus, and the other end anterior to the aorta/pulmonary trunk will allow complete blockage of blood output. This is performed during some [[Cardiothoracic surgery|heart surgeries]].{{Citation needed|date=November 2020}}

== Clinical significance ==
During [[pericardial effusion]], [[Pericardial fluid|fluid]] may build up in the pericardial sinuses.<ref name=":2">{{Citation|last=Oxorn|first=Donald C.|title=9 - Pericardial disease|date=2018-01-01|url=http://www.sciencedirect.com/science/article/pii/B978032335825500018X|work=Intraoperative and Interventional Echocardiography (Second Edition)|pages=311–322|editor-last=Oxorn|editor-first=Donald C.|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-35825-5.00018-x|isbn=978-0-323-35825-5|access-date=2020-11-16|last2=Otto|first2=Catherine M.|editor2-last=Otto|editor2-first=Catherine M.}}</ref> This may be diagnosed with [[Transesophageal echocardiogram|transoesophageal echocardiography]].<ref name=":2" />


==References==
==References==
{{Gray's}}
<references/>
<references/>


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* {{NormanAnatomy|thoraxlesson4}} ({{NormanAnatomyFig|pericardialsinuses}})
* {{NormanAnatomy|thoraxlesson4}} ({{NormanAnatomyFig|pericardialsinuses}})


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[[Category:Cardiac anatomy]]
[[Category:Cardiac anatomy]]

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Revision as of 07:36, 28 January 2023

The pericardial sinuses are impressions in the pericardial sac formed between the points where great vessels enter it.

Pericardial sinus
Posterior wall of the pericardial sac, showing the lines of reflection of the serous pericardium on the great vessels. (Transverse sinus labeled at center. Oblique sinus not labeled, but visible inferior to transverse sinus between the right and left pulmonary veins)
Identifiers
TA98A12.1.07.001
TA23349
FMA77132
Anatomical terminology

Structure

There are three pericardial sinuses: superior, transverse and oblique.[1]

Clinical significance

During pericardial effusion, fluid may build up in the pericardial sinuses.[3] This may be diagnosed with transoesophageal echocardiography.[3]

References

Public domain This article incorporates text in the public domain from page 526 of the 20th edition of Gray's Anatomy (1918)

  1. ^ a b c d e Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (2019-01-01), Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (eds.), "27 - Epicardial Ventricular Tachycardia", Clinical Arrhythmology and Electrophysiology (Third Edition), Philadelphia: Elsevier, pp. 907–924, doi:10.1016/b978-0-323-52356-1.00027-x, ISBN 978-0-323-52356-1, retrieved 2020-11-16
  2. ^ a b Klick, John C.; Ali, Jafer; Avery, Edwin G. (2014-01-01), Reich, David L.; Fischer, Gregory W. (eds.), "23 - Echocardiographic Evaluation of Pericardial Disease", Perioperative Transesophageal Echocardiography, Philadelphia: W.B. Saunders, pp. 253–264, doi:10.1016/b978-1-4557-0761-4.00023-2, ISBN 978-1-4557-0761-4, retrieved 2020-11-16
  3. ^ a b Oxorn, Donald C.; Otto, Catherine M. (2018-01-01), Oxorn, Donald C.; Otto, Catherine M. (eds.), "9 - Pericardial disease", Intraoperative and Interventional Echocardiography (Second Edition), Elsevier, pp. 311–322, doi:10.1016/b978-0-323-35825-5.00018-x, ISBN 978-0-323-35825-5, retrieved 2020-11-16
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