Transverse pericardial sinus
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The transverse pericardial sinus is the transverse communication between the left and right parts of the pericardial space proper behind the two outflow arteries of the heart.
It is superior to the left atrium and posterior to the intrapericardial parts of the pulmonary trunk and ascending aorta and anterior to the superior vena cava on the right and the left atrial appendage on the left. Inferiorly it is separated from the oblique pericardial sinus below by a double reflection of serous pericardium that extends transversely between the left and right superior pulmonary veins.
Several pericardial recesses form small pockets that may extend from or towards the transverse sinus, which may mimic mediastinal lymph nodes or disease:
- aortic recesses
- pulmonic recesses
- postcaval recess
- pulmonary venous recesses
During cardiac surgery, the transverse pericardial sinus allows a surgeon to isolate the pulmonary trunk and ascending aorta and apply a temporary ligature or clamp.
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