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Which treatment in pericardial effusion?
A Campione1, M Cacchiarelli, C Ghiribelli
1Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy.
The Journal of Cardiovascular Surgery
|October 19, 2002
Summary
The best treatment for pericardial effusion depends on the patient’s condition. Pericardiocentesis is ideal for acute cardiac tamponade, while VATS pleuro-pericardial window suits chronic effusions.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Pericardial effusion management involves various surgical techniques.
- Choosing the right method depends on patient factors and effusion characteristics.
- This study reviewed 64 cases over five years to compare treatment outcomes.
Purpose of the Study:
- To evaluate the effectiveness of different surgical methodologies for treating pericardial effusion.
- To determine the optimal treatment strategy based on effusion type and patient condition.
Main Methods:
- Retrospective review of 64 patients with pericardial effusions (acute, subacute, chronic).
- Analysis of patient demographics, effusion aetiology (neoplastic vs. non-neoplastic), and treatment interventions.
- Surgical procedures included pericardiocentesis, subxiphoid drainage, pericardioscopy, and pleuro-pericardial window creation (VATS and thoracotomy).
Main Results:
- Acute effusions with cardiac tamponade were treated with echo-guided pericardiocentesis.
- Subxiphoid drainage was performed in 43 cases, with 4 including pericardioscopy.
- A pleuro-pericardial window was created via VATS (13 cases) or thoracotomy (4 cases).
Conclusions:
- Pericardiocentesis is preferred for acute pericardial effusion with cardiac tamponade to avoid general anesthesia.
- Video-assisted thoracoscopic surgery (VATS) pleuro-pericardial window is recommended for chronic effusions or recurrence after subxiphoid drainage.
- Subxiphoid drainage is suitable for neoplastic effusions and when pericardioscopy is needed for unknown aetiologies.