Management of cardiac tamponade in patients with malignancy

From January 1967 through November 1983, 66 patients with a previously established diagnosis of malignancy were treated for pericardial effusion by the creation of a pericardial window. The majority of the patients had malignancies of the breast or lung, or lymphoma. There were no deaths or major complications attributable to the operative procedures. The presence of malignant pericardial effusion is usually evidence of far-advanced disease and, therefore, the prognosis is poor. Seventeen patients (26%) were alive 1 or more years postoperatively and 33 patients (50%) died within 3 months of operation. Despite the grave prognosis, it is still our belief that malignant pericardial effusion should be treated aggressively by open surgical drainage so that continuation of therapy for the primary malignancy would be possible.