The subxiphoid approach to pericardial disease

Area of Science:

• Cardiology
• Thoracic Surgery
• Nephrology

Background:

• Pericardial effusions pose diagnostic and therapeutic challenges.
• Uremic, malignant, and tuberculous pericarditis require distinct management strategies.

Purpose of the Study:

• To evaluate the efficacy of the subxiphoid pericardial window procedure.
• To assess its utility in diagnosing and treating various pericardial effusion etiologies.

Main Methods:

• A retrospective analysis of 25 patients undergoing subxiphoid pericardial window.
• Patients were grouped by suspected etiology: uremic pericarditis, malignancy, or diagnostic uncertainty.

Main Results:

• Successful treatment of uremic effusions in 11/12 patients post-dialysis.
• Diagnosis of malignancy confirmed in 6 patients, with 1 long-term survivor.
• 4/7 patients with suspected tuberculous pericarditis achieved asymptomatic status with chemotherapy.

Conclusions:

• Subxiphoid pericardial window is effective for uremic effusions and tuberculous pericarditis management.
• Careful patient selection is crucial for suspected malignant pericardial disease.
• This procedure offers diagnostic and therapeutic benefits across diverse pericardial conditions.