Pericardial sinus

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
TA98	A12.1.07.001
TA2	3349
FMA	77132
Anatomical terminology [edit on Wikidata]

Structure

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

The superior sinus is anterior to the ascending aorta and the pulmonary trunk.^[1] It cannot be assessed in electrophysiology procedures.^[1]

The oblique sinus is an inverted J-shaped reflection of the venae cavae and pulmonary veins.^[2] It lies behind the atria (particularly the left atrium),^[1] 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.^[1]^[2] 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 heart surgeries.^{[citation needed]}

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

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

^ ^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
^ ^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
^ ^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

Anatomy photo:20:04-0101 at the SUNY Downstate Medical Center - "Heart: Transverse and Oblique Pericardial Sinuses"
thoraxlesson4 at The Anatomy Lesson by Wesley Norman (Georgetown University) (pericardialsinuses)

Anatomy of the heart

General

Surface

Internal

atria interatrial septum pectinate muscles terminal sulcus ventricles interventricular septum trabeculae carneae chordae tendineae papillary muscle valves cusps atrioventricular septum
cardiac skeleton intervenous tubercle

Chambers

Right heart	(venae cavae, coronary sinus) → right atrium (atrial appendage, fossa ovalis, limbus of fossa ovalis, crista terminalis, valve of inferior vena cava, valve of coronary sinus) → tricuspid valve → right ventricle (infundibulum, moderator band/septomarginal trabecula, crista supraventricularis), → pulmonary valve → (pulmonary artery and pulmonary circulation)
Left heart	(pulmonary veins) → left atrium (atrial appendage) → mitral valve → left ventricle → aortic valve (aortic sinus) → (aorta and systemic circulation)

Layers

Endocardium	heart valves
Myocardium	Conduction system cardiac pacemaker SA node Bachmann's bundle AV node bundle of His bundle branches Purkinje fibers
Pericardial cavity	pericardial sinus
Pericardium	fibrous pericardium sternopericardial ligaments serous pericardium epicardium/visceral layer fold of left vena cava

Blood supply

This page was last edited on 28 January 2023, at 07:36