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Pericardial window for malignant pericardial effusion

J R Hankins, J R Satterfield, J Aisner

    The Annals of Thoracic Surgery
    |November 1, 1980
    PubMed
    Summary
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    Creating a pericardial window effectively treats malignant pericardial effusion, offering immediate relief from cardiac compression with minimal risk. The subxiphoid approach is preferred for this life-saving procedure.

    Area of Science:

    • Cardiology
    • Surgical Oncology
    • Thoracic Surgery

    Background:

    • Malignant pericardial effusion poses a significant risk of cardiac compression.
    • Effective management is crucial for patient survival and quality of life.

    Purpose of the Study:

    • To evaluate the efficacy and safety of pericardial window creation for malignant pericardial effusion.
    • To determine the optimal surgical approach for this condition.

    Main Methods:

    • Seventeen patients with malignant pericardial effusion underwent pericardial window creation.
    • Procedures were performed via subxiphoid approach (13 patients) or limited anterior thoracotomy/sternotomy (4 patients).

    Main Results:

    • No operative deaths or major complications occurred.

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  • All patients experienced immediate and complete relief of cardiac compression.
  • No significant recurrence of effusion was observed; one patient required pericardiectomy for constriction post-irradiation.
  • Survival was primarily dictated by the extent of the underlying malignancy.

    • Conclusions:

    • Pericardial window creation, particularly the subxiphoid approach, is the preferred treatment for malignant pericardial effusion.
    • The procedure offers accurate diagnosis, minimal mortality/morbidity, and durable relief of cardiac compression.