An Experimental Study of Cardiopericardial Adhesions. ∗

Abstract

The generally accepted conclusion that pericardial adhesions play a fundamental rôle in the production of cardiac hypertrophy has been widely taught and approved. 1 Doubt was cast upon this established point of view by the many experimental operations on the heart and pericardium carried out during the past 12 years by Beck 2 and his associates. An additional reason for the study of this subject lies in the fact that the myocardium can be given a new blood supply through tissues grafted upon the heart. The Beck operation 3 involves myocardial adhesions and the rôle of adhesions needs critical study if coronary sclerosis is to be treated by this new surgical principle.

Twenty-six dogs were divided into 2 groups. In one group the pericardium alone was attached to the dome of either diaphragm. In the other group the myocardium and pericardium were attached to the diaphragm. The attachment was made well lateral to the central tendon of the diaphragm. This displaced the heart to either side. Attachment was always made so as to produce marked tension between diaphragm and pericardium. Various observations and studies were carried out on these animals over a period of 2 1/2 years.

Signs of circulatory embarrassment were not encountered in a single instance. The response of the animals to exercise tolerance tests was normal. The observation of greatest importance was that cardiac hypertrophy was not found either grossly or microscopically.†

This is borne out by the fact that the mean heart weight to body weight ratio in our series of dogs in which the heart was displaced to the left by the attachment of the pericardium alone was 0.00713; while the mean ratio for the group in which the displacement was to the right was 0.00696.