[Management of malignant pericardial effusion with parasternal fenestration]

Numerous methods exist for the treatment of pericardial effusions. These methods, however, can be applied with limitations only for long-term eradication of malignant pericardial effusion. Lately, several new methods, including minimally invasive procedures, have been published, and the VATS technique has become fairly popular. This technique needs special instruments and single lung ventilation, which is relatively risky in case of contralateral malignancy. We apply a new and simple minimally invasive fenestration method using the well-known approach of the parasternal mediastinoscopy by Stemmer. No recurrence of pericardial effusions was noted in long-term follow-up. In the past 10 years 73 patients were treated for pericardial effusion in our department and 22 pericardium fenestrations have been performed with parasternal approach. This method is recommended for the definitive treatment of pericardial effusion with malignant origin.