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Pericardial drainage procedures

D W Moores1, S W Dziuban

  • 1Division of Cardiothoracic Surgery, Albany Medical College, New York, USA.

Chest Surgery Clinics of North America
|May 1, 1995
PubMed
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Pericardial drainage is crucial for diagnosing and treating pericardial effusion and cardiac tamponade. The subxiphoid approach is preferred for its safety and effectiveness in most cases.

Area of Science:

  • Cardiology
  • Thoracic Surgery

Background:

  • Pericardial effusion and cardiac tamponade necessitate pericardial drainage for diagnosis and treatment.
  • Multiple drainage techniques exist, each with unique benefits and drawbacks, lacking a universal optimal method.

Purpose of the Study:

  • To review and compare various pericardial drainage techniques.
  • To highlight the advantages of the subxiphoid approach for pericardial drainage.

Main Methods:

  • Review of established pericardial drainage procedures including pericardiocentesis, percutaneous tube drainage, and the subxiphoid approach.
  • Discussion of risks, benefits, and optimal patient selection for each technique.

Main Results:

  • Pericardiocentesis and percutaneous drainage are options for acute tamponade but carry risks, requiring controlled settings.

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  • The subxiphoid approach offers rapid pericardial access, low morbidity, and excellent long-term outcomes, making it the preferred method for most patients.
  • Infectious pericarditis requires close monitoring post-drainage, with potential need for early pericardiectomy, particularly in pediatric cases involving H. influenzae.

    • Conclusions:

    • The subxiphoid approach is a highly effective and safe method for pericardial drainage in the majority of patients.
    • Pericardiectomy is reserved for specific conditions like constrictive pericarditis or treatment failures.
    • Careful patient selection and monitoring are essential for managing pericardial diseases.