The impact of coronary heart disease and myocardial infarction on pericardial destruction in patients undergoing Ozaki surgery

Introduction: In modern cardiac surgery, the Ozaki procedure is one of the preferred methods for treating aortic valve diseases.This study examines histological changes in the pericardium associated with comorbidities, addressing a gap in the literature regarding the impact of ischemic heart disease (IHD) and myocardial infarction (MI) on the structure of the human pericardium. Objective: To evaluate the influence of IHD and MI on the human pericardium, evaluate the impact of comorbidities on pericardial structure, and compare the histological properties of glutaraldehyde-treated pericardium with untreated samples. Methods: Pericardial samples from 98 patients who underwent cardiac surgery were analyzed. Patients were divided into two groups based on their IHD status. Histological examination evaluated mesothelial integrity, collagen fiber organization, and inflammatory changes. Statistical analyses, including chi-square tests and ROC analysis, assessed the prognostic role of IHD and MI in pericardial destruction. Artificial neural networks further analyzed the prognostic significance of these comorbidities. Results: Histological analysis revealed significant structural deterioration in the pericardium of patients with IHD and MI, including mesothelial changes, collagen necrosis, and inflammatory infiltration. ROC analysis demonstrated high prognostic sensitivity of IHD and MI in pericardial destruction (AUC 0.915 for IHD and 0.849 for MI). Notably, no histological differences were observed between glutaraldehyde-treated and untreated pericardium under light microscopy. Conclusions: IHD and MI significantly contribute to pericardial destruction, which may impact surgical outcomes after the Ozaki procedure. Glutaraldehyde treatment does not alter pericardial structure microscopically.