Subxiphoid pericardial window for pericardial effusive disease

Area of Science:

• Cardiology
• Thoracic Surgery
• Oncology

Background:

• Pericardial effusions can be caused by malignancy or benign conditions, requiring effective drainage and diagnosis.
• Diagnostic and therapeutic challenges exist in managing pericardial effusions, particularly differentiating malignant from benign causes.

Purpose of the Study:

• To evaluate the efficacy and safety of the subxiphoid pericardial window procedure for draining and diagnosing pericardial effusions.
• To assess recurrence rates and patient outcomes in both malignant and benign effusion groups.

Main Methods:

• A subxiphoid pericardial window was created in 123 patients with pericardial effusions.
• Drainage volume, cytology, and pericardial biopsy results were analyzed for diagnostic yield.
• Recurrence rates, subsequent interventions, and 30-day mortality were recorded.

Main Results:

• Median drainage was 450 ml for malignant effusions and 400 ml for benign effusions.
• Cytology was positive in 47% and biopsy in 43% of malignant cases; 11 patients with malignancy had negative cytology and biopsy.
• Recurrence occurred in 11% of patients (9 benign, 5 malignant); 30-day mortality was 25% in the malignant group and 11% in the benign group.

Conclusions:

• The subxiphoid pericardial window is a rapid, safe, and effective method for draining pericardial effusions.
• The procedure allows for tissue sampling for diagnosis with minimal morbidity and low recurrence rates.
• It provides a valuable tool in the management of both malignant and benign pericardial effusions.