Pericardiacophrenic Artery

arteria pericardiacophrenica

The pericardiacophrenic artery is a long slender branch of the internal thoracic artery that accompanies the phrenic nerve from the thoracic inlet to the diaphragm. It supplies the pericardium, the pleura, and the diaphragm in company with the phrenic nerve, and anastomoses inferiorly with the musculophrenic artery. It is the anatomical basis of the companion artery to the phrenic nerve throughout the thorax.

Region: Chest

Clinical Relevance

Clinical Notes

The pericardiacophrenic artery is the vessel that must be preserved or sacrificed alongside the phrenic nerve in thoracic surgery involving the pericardium and mediastinum. During pericardectomy for constrictive pericarditis, both pericardiacophrenic arteries are divided as the pericardium is peeled from the cardiac surfaces. The artery provides the blood supply to the phrenic nerve and its sacrifice with the phrenic nerve in radical resection of lung, pleural, or mediastinal tumours devascularises the phrenic nerve, worsening the prognosis for nerve recovery. In pericardioscopy and pericardial window procedures, this artery is the lateral pericardial landmark.

Pathology

Common Injuries & Conditions

Phrenic Nerve Devascularisation in Thoracic Surgery

Radical resection of superior sulcus and mediastinal tumours requiring phrenic nerve sacrifice also divides the pericardiacophrenic artery; when nerve-sparing is planned for borderline resectable tumours, the pericardiacophrenic artery must also be preserved as it is the sole blood supply to the thoracic phrenic nerve.