The pericardiacophrenic ligament connects the fibrous pericardium to the central tendon of the diaphragm, anchoring the heart-pericardium complex inferiorly and transmitting pericardial forces to the diaphragm during respiration.
Provides inferior pericardial stabilisation, transmits respiratory diaphragmatic movement to the pericardium and heart, and contains the pericardiacophrenic artery and vein with the phrenic nerve.
The pericardiacophrenic ligament is divided during pericardial window creation for effusion drainage. The phrenic nerve runs within this ligament complex — its identification and preservation is critical during pericardial surgery to prevent diaphragmatic paralysis.
The phrenic nerve running within the pericardiacophrenic ligament must be identified and protected during pericardial window creation and pericardiectomy.
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