Single-Port Thoracoscopic Pericardial Window Under Local Anesthesia

Area of Science:

• Cardiothoracic Surgery
• Oncology
• Anesthesiology

Background:

• Pericardial effusions are common in metastatic breast cancer, requiring drainage.
• Optimal surgical management remains debated, especially in palliative patients.
• General anesthesia and invasive procedures can delay critical chemotherapy.

Observation:

• A 44-year-old woman with metastatic breast cancer presented with a symptomatic pericardial effusion.
• Medical comorbidities precluded general anesthesia.
• Urgent chemotherapy initiation was necessary.

Findings:

• A single-port thoracoscopic pericardial window was successfully performed under local anesthesia and light sedation.
• The patient remained spontaneously ventilating without intubation.
• The minimally invasive approach facilitated rapid symptom relief and prompt discharge.

Implications:

• This awake, single-port technique is a viable alternative for pericardial effusion drainage in high-risk patients.
• It enables timely initiation of oncologic therapy.
• This approach minimizes invasiveness and anesthetic risks, improving patient outcomes.