Deep Dive Into Aortic Surgery: Visceral Pericardium—The Last Line of Defense

The visceral pericardium is a defined layer of connective tissue that covers the heart and the great vessels. It provides additional strength to the ascending aorta and can be regarded as the last line of defense in acute type A aortic dissection and impending rupture. It may well be the only layer of tissue holding the dissected aorta together before it ruptures. The number of patients who present with impending rupture is underestimated, as these patients are generally regarded as having a type A aortic dissection with hemopericardium. However, have you wondered why some patients present with hemopericardium and some don't with acute type A dissection, and from where does the blood get into the pericardium?

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