Percutaneous balloon pericardiotomy using the Inoue balloon for patients with recurrent pericardial tamponade

Recurrent pericardial effusion is often caused by pericardial metastases of extra-cardiac tumours. These effusions may be moderate to severe, leading to cardiac tamponade. The treatment is emergency pericardiocentesis but in spite of the initial success of that treatment, the effusions have high recurrence rates. Here we describe our experience of percutaneous balloon pericardiotomy (PBP) using the Inoue balloon for the management of three patients with malignant pericardial effusions secondary to lung cancer.

In our clinic, three patients with recurrent pericardial effusion secondary to lung cancer were treated with percutaneous pericardiotomy with an Inoue valvuloplasty balloon catheter through the subxiphoid approach.

Successful drainage with balloon pericardiotomy was achieved in all patients without severe complications. In all cases, only one pericardial site was dilated at least three times. During the four to six months of follow up, there were no recurrences of the effusion or tamponade. All patients were still alive.

In our experience, PBP with the Inoue balloon appears to be a simple and safe procedure with a high success rate. PBP is an effective method for the management of patients with recurrent, large, malignant pericardial effusions.