Percutaneous balloon pericardiotomy: non-surgical treatment for patients with cardiac tamponade

We present two patients with recurrent large pericardial effusions who were treated with balloon pericardiotomy. This is a novel treatment in which a non-surgical pericardial window is created via the percutaneous subxiphoid route using a balloon dilating catheter. Our two patients initially had standard pericardiocentesis performed. However, large pericardial effusions soon returned in both patients so further and more definitive treatment was required. Following balloon pericardiotomy, neither patient developed a significant pericardial effusion after months of follow up. Given our experience with percutaneous balloon pericardiotomy, as well as the experience of others, we believe that this approach will become the preferred treatment for large pericardial effusions or tamponade, especially in patients with cancer.