The use of pleurodesis for intractable pleural effusion due to congestive heart failure

Abstract

Summary Two patients in whom pleurodesis was used for intractable pleural effusion due to congestive heart failure are described. This procedure eliminated the pleural effusion but resulted in accumulation of fluid in other body compartments. Pleurodesis has a limited role in the treatment of intractable pleural transudates in congestive heart failure.

The Use of a PleurX Catheter in the Management of Recurrent Benign Pleural Effusion: A Concise Review

“…In rare circumstances, the pleural effusions are rapidly recurring despite optimal medical therapy, and patients have frequent hospitalisation and repeated thoracenteses. Besides medical therapy and repeat thoracentesis, treatment options are limited to chest tube placement and chemical pleurodesis [13,14] or, rarely, surgical pleurodesis [15].…”

The use of the PleurX catheter in the management of non-malignant pleural effusions

“…19 Although most patients with CHF or pleural effusions related to end stage liver diseases can be adequately managed medically, some fail medical management and the physician is confronted with symptomatic patients that require recurrent thoracenteses for symptomatic relief. Besides therapeutic thoracenteses, treatment options are limited to chest tube placement with chemical pleurodesis 6,7,20 or less commonly surgical pleurodesis. 9,10 In the case of hepatic hydrothorax, closure of diaphragmatic holes if present is also performed during the surgical exploration.…”

“…2,3,7 The PleurX catheter (Denver Biomedical, Golden, CO, USA) has been used to treat recurrent malignant pleural effusions on an outpatient basis. It is placed under local anesthesia with or without conscious sedation.…”

Pleurodesis for Refractory Left-Sided Pleural Effusion Due to Cardiomyopathy in a Patient with Right-Sided Destroyed Lung

“…In patients with congestive heart failure, pulmonary venous hypertension causes increased production of pleural fluid as an ultrafiltrate from the capillaries in the parietal pleura and decreased reabsorption of fluid into the capillaries of the visceral pleura, both leading to in pleural effusion. Although the incidence of heart failure is high and over half of these patients will develop pleural effusions during the course of their illness, there is no consensus on the treatment of recurrent benign pleural effusion (6)(7)(8). Here, we present a case of reccurent left-sided massive pleural effusion due to dilated cardiomyopathy who was treated with pleurodesis.…”

“…Although pleurodesis has been studied widely accepted mode of treatment for malignant pleural effusion, (4,5) pleurodesis in nonmalignant cases of pleural effusion is less commonly performed and reported (6)(7)(8). In this report, we present a case of right-sided destroyed lung and reccurent leftsided massive pleural effusion due to cardiomyopathy who was treated with pleurodesis.…”