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The heart is enclosed in a membranous sac called the pericardium. It has two layers- the fibrous pericardium which is the outer layer and the serous pericardium that lies inside the fibrous pericardium. The serous pericardium has two layers - the outer parietal and the inner visceral layer. The parietal layer lines the fibrous pericardium and the visceral layer the surfaces of the heart. This visceral layer is also called the epicardium.
The pericardium is conical in shape, the base being directed downwards and is partly fused with the tendon of the diaphragm. The apex is the upper end and is fused with the great blood vessels.
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Sub Xyphoid Pericardial Window : It could be done under local or general anaesthesia. A small vertical midline incision is made over the xyphoid process on to the linea alba
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