Treatment of Pericardial Effusion Through Subxiphoid Tube Pericardiostomy and Computerized Tomography- or Echocardiography - Guided Percutaneous Catheter Drainage Methods

Abstract

Objective In this retrospective study, we aimed to observe the efficacy of pericardial effusion (PE) treatments by a survey conducted at the Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University. Methods In order to get comparable results, the patients with PE were divided into three groups - group A, 480 patients who underwent subxiphoid pericardiostomy; group B, 28 patients who underwent computerized tomography (CT)-guided percutaneous catheter drainage; and group C, 45 patients who underwent echocardiography (ECHO)-guided percutaneous catheter drainage. Results In the three groups of patients, the most important symptom and physical sign were dyspnea and tachycardia, respectively. The most common causes of PE were uremic pericarditis in patients who underwent tube pericardiostomy, postoperative PE in patients who underwent CT-guided percutaneous catheter drainage, and cancer-related PE in patients who underwent ECHO-guided percutaneous catheter drainage. In all the patients, relief of symptoms was achieved after surgical intervention. There was no treatment-related mortality in any group of patients. In patients with tuberculous pericarditis, the rates of recurrent PE and/or constrictive pericarditis progress were 2,9% and 2,2% after tube pericardiostomy and ECHO-guided percutaneous catheter drainage, respectively. Conclusion Currently, there are many methods to treat PE. The correct treatment method for each patient should be selected according to a very careful analysis of the patient's clinical condition as well as the prospective benefit of surgical intervention.

Subxiphoid Tube Pericardiostomy in the Management of Pericardial Effusion: Our Experience

“…Over 60% of our patients had their procedure performed under local anaesthesia which has been reported as the preferred from of anaesthesia for this procedure. Becit et all and other reported that over 90% of their patients had their procedure done using local anaesthesia [7,34,35]. All the children in our series had drainage under general anaesthesia.…”

The Association of Minimally Invasive Surgical Approaches and Mortality in Patients with Malignant Pleuropericarditis—A 10 Year Retrospective Observational Study

“…As chemical pleurodesis treatment we preferred to use betadine over talc. The literature warns against significant side effects in using chemical pleurodesis with talc, such as fever, chest pain [20], cough, infection at the insertion of the drain, bronchospasm, allergic reaction, arrhythmias, pulmonary edema, pneumonia, respiratory failure, and acute respiratory distress syndrome [21,22]. Other studies found even more disadvantages of talc chemical pleurodesis in malignancies, such as fixation of the lung parenchyma at the level of the pleuropericardial window, which causes pericardial constriction [23,24].…”

Pericarditis. Clinical Guidelines 2022

“…С целью декомпрессии сердца, дренирования и санации полости перикарда в настоящее время применяются такие методы лечения, как перикардиоцентез, открытое подмечевидное дренирование перикарда с формированием перикардиального окна, торакоскопическое формирование перикардиального окна (или фенестрация перикарда) и перикардэктомия [6,[166][167][168].…”