Emergency subxiphoid pericardial decompression for malignant pericardial effusion

Area of Science:

• Cardiology
• Thoracic Surgery
• Oncology

Background:

• Malignant pericardial effusion can lead to acute cardiac tamponade, a life-threatening condition.
• General anesthesia poses significant risks for patients with hemodynamic compromise.
• Prompt pericardial decompression is crucial for symptom relief.

Purpose of the Study:

• To evaluate the safety and efficacy of a pericardial window procedure performed under local anesthesia for malignant pericardial effusion.
• To assess the feasibility of this approach for general and thoracic surgeons.

Main Methods:

• A series of 12 patients with malignant pericardial effusion underwent a pericardial window procedure.
• The surgery was performed using local anesthesia via an upper abdominal midline incision.
• Chest tubes were placed to drain the effusion and removed after 3-7 days.

Main Results:

• No operative mortality was observed in the 12 patients.
• The procedure effectively decompressed the pericardium, relieving symptoms.
• No recurrence of effusion was noted post-treatment.
• Average survival time was 27 weeks (range: 2-153 weeks).

Conclusions:

• A pericardial window procedure under local anesthesia is a safe and effective treatment for malignant pericardial effusion.
• This minimally invasive technique is suitable for general and thoracic surgeons.
• It provides significant palliation for patients with cardiac tamponade due to malignancy.