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The management of malignant pericardial effusions using permanently implanted devices
Franca M A Melfi1, Gian Franco Menconi, Antonio Chella
1Division of Thoracic Surgery-Cardiac and Thoracic Department, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy. f.melfi@med.unipi.it
Summary
This study introduces a novel approach for managing recurrent pericardial effusion in advanced cancer patients using video-assisted thoracoscopic surgery (VATS) and a port system for home drainage. This method enables patients to manage symptoms effectively at home.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Recurrent pericardial effusion is a common complication in advanced malignancy.
- Managing symptomatic effusions often requires repeated invasive procedures.
- Existing management strategies can be burdensome for patients with advanced disease.
Purpose of the Study:
- To present a new minimally invasive approach for the management of recurrent pericardial effusion.
- To enable home-based management of pericardial effusion in patients with advanced cancer.
- To evaluate the feasibility of a permanently implanted port system for effusion drainage.
Main Methods:
- Video-assisted thoracoscopic surgery (VATS) was utilized to create a pericardial window.
- A subcutaneous port system (Medi-Port MP-GS9; IAP-HMP) was permanently implanted.
- The port system's catheter was placed in the pleural cavity for effusion aspiration.
Main Results:
- The procedure allowed for effective pericardial window creation via VATS.
- Permanent implantation of a port system was successfully achieved in all patients.
- The system facilitates at-home aspiration of pericardial effusion by patients when symptomatic.
Conclusions:
- This VATS and port system approach offers a viable solution for home management of recurrent pericardial effusion.
- It improves patient quality of life by enabling self-management of symptoms.
- This technique is suitable for patients with advanced malignancy and recurrent effusions.