Subxiphoid approach to the pericardium

Pericardiotomy was performed via the subxiphoid route in 19 patients, 7 with benign and 12 with malignant disorders. Partial pericardial resection ('fenestration') was undertaken in nine of the patients with malignant disease, and pericardial tube drainage or insertion of pacemaker electrode in the other ten patients. There were no intraoperative deaths. The 16% hospital mortality was attributable to the underlying disease. Subxiphoid pericardial decompression is a simple, safe and effective procedure in the management of pericardial effusion. Particularly in malignant conditions it can give excellent palliation.