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Subxiphoid pericardial drainage for pericardial tamponade
D W Moores1, K B Allen, L P Faber
1Department of Surgery, Albany Medical Center, N.Y.
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1995
Summary
Subxiphoid pericardial drainage effectively treats pericardial tamponade with low recurrence rates. While survival varies by underlying cause, this procedure offers a safe and quick option for patients needing pericardial effusion management.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Pericardial effusion leading to cardiac tamponade is a critical condition.
- Video-assisted thorascopic pericardiectomy has gained recent attention.
- Subxiphoid pericardial drainage is an alternative minimally invasive approach.
Purpose of the Study:
- To review the experience and outcomes of subxiphoid pericardial drainage for pericardial effusion with tamponade.
- To evaluate the efficacy and safety of this procedure in a diverse patient population.
Main Methods:
- A retrospective review of 155 patients undergoing subxiphoid pericardial drainage between August 1988 and June 1993.
- Data collected included patient demographics, underlying disease (cancer vs. benign), anesthesia type, and outcomes.
- Follow-up was complete for all patients, assessing mortality, recurrence, and survival.
Main Results:
- The overall 30-day mortality was 20%, significantly higher in cancer patients (32.9%) than benign disease patients (5.4%).
- Recurrent pericardial tamponade occurred in only 2.5% of patients, regardless of underlying disease.
- Median survival was significantly longer for patients with benign disease (>800 days) compared to those with cancer (83 days).
Conclusions:
- Subxiphoid pericardial drainage is a safe, quick, and effective procedure for managing pericardial tamponade.
- It is associated with minimal morbidity and a low rate of recurrent tamponade.
- The procedure is considered the procedure of choice for patients presenting with pericardial tamponade.