Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions

Abstract

Objective -

The Role of Videopericardioscopy in Evaluating Indeterminate Pericardial Effusions

“…In a previous article published by our group [Pêgo- Fernandes 2001], the frequency of diagnostic positivity for biopsy performed by videopericardioscopy for pericardial effusion was 30% in a group of 20 patients. A fluid analysis ensures an etiologic diagnosis in 15% of the patients.…”

Utilidade da pericardioscopia no diagnóstico de derrame pericárdico

“…The pericardial biopsy is the most commonly performed procedure 4 . The access route for pericardial biopsy may be transthoracic, median sternotomy, or subxiphoid 2 . The examination of the effusion is troublesome, as there are cytological and microbiological limitations in the analysis of the pericardial fluid 3,4 .…”

“…The traditional subxiphoid approach allows very limited exposure of the pericardium, resulting in a low index of etiologic diagnosis and in rates of recurrence of pericardial effusion of up to 20% 5 . With the development of endoscopic equipment, it was possible to introduce new techniques, such as video-assisted pericardioscopy 2,3 and thoracoscopic pericardial window 6,7 .…”

“…Clinical investigation and the current imaging methods have made the diagnosis of pericardial effusion and tamponade a routine practice. However, the same is not true in regard to determining its etiology 2 . Therefore, pericardial biopsy has an important role in the evaluation of indeterminate pericardial effusions.…”

Metastastic Gastric Adenocarcinoma: Diagnosis through Pericardioscopy

“…The etiological diagnosis of lesions did through the pericardial cytology and microbiological studies have its limitations, being the biopsy the best investigative method [4]. A pericardioscopy watched video provides a better view of the biopsy site, increasing the diagnostic yield [4].…”