Intrapericardial Administration to Achieve Localized and Targeted Treatment for Cardiac Disease

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Abstract
Intrapericardial administration has been proposed as an alternative delivery route of pharmacological agents via the bilaminar sac of pericardium surrounding the heart. To date, intrapericardial administration has entailed the localized administration of a broad spectrum of therapeutic agents. These agents include stem cells, extracellular matrix, growth factor, drugs, bioactive materials, and genetic materials, to the heart and coronary arteries. The route not only overcomes the limitations associated with traditional systemic administration methods, but also presents multiple intrinsic advantages over the other approaches, allowing greater therapeutic actions. Intrapericardial administration exhibits versatility in addressing certain cardiac conditions and ongoing research in this field certainly holds promise for further innovations and advancements to improve cardiac treatment. Thus, this review discusses the anatomy and physiology of the pericardium, the intrapericardial administration access routes, the recent application of intrapericardial delivery in the context of cardiac repair as well as the challenges associated with the approach. Graphical Abstract

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