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Normal Pericardial Anatomy - Pericardial Sinuses and Recesses - I

Pericardial sinuses - anterior view grossA. The anterior portion of the pericardial sac and the heart have been removed. This view exposes the lateral, dorsal and diaphragmatic aspects of the pericardial sac. The visceral and parietal pericardium are continuous at the basal region of the heart where the great arteries and veins are located. The aorta and pulmonary trunks are enclosed in one sheath while the pulmonary veins and venae cavae are covered separately.
B. The transverse sinus (black arrow path) is the space between the arterial and venous pericardial reflections that forms an access between the right and left sides of the pericardial cavity. The cul-de-sac behind the left atrium bounded by the pulmonary veins is called the oblique sinus (white interrupted line area).

SVC = Superior vena cava, Ao = Aorta, LPA = Left pulmonary artery, RPA = Right pulmonary artery, LPV = Left pulmonary veins, RPV = Right pulmonary veins, IVC = Inferior vena cava.

In this image the anterior (ventral) portion of the pericardium and the heart have been removed to show the great vessels at the base of the heart. The aorta and pulmonary artery has been transected to show the path of the transverse sinus (dotted line) that separates the arteries from the venae cavae and pulmonary veins. The pericardial reflection extends to the proximal aortic arch and the recess between the aorta and the superior vena cava is called the superior aortic recess (dotted line). The left lateral extension of the transverse sinustransverse sinus is the left pulmonic recess bordered by the left pulmonary artery and left superior pulmonary vein. The oblique sinusoblique sinus is the cul-de-sac behind the left atrium and bound by the pericardial reflection over the inferior pulmonary veins and the inferior vena cava.

IVC = inferior vena cava. LPA = left pulmonary artery. LPV = left pulmonary veins. RPA = right pulmonary artery. RPV = right pulmonary veins. SVC = superior vena cava.

Right and left lateral views of the transverse sinus are demonstrated here.

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