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Make an incision in the anterior wall of the pericardial sac in the area above the right atrium, and open the pericardial sac as widely as the dissection field will allow (Figure 20.2). The inner surface of the pericardial sac and the surface of the heart are covered by a serous membrane called the pericardium. It is a continuous membrane that forms a closed space called the pericardial cavity.

The fibrous parietal pericardium [probe] is the rough outer layer of the pericardial sac. It is continuous with the external walls of the great vessels superiorly and blends with the fascia of the diaphragm inferiorly.