Thoracoscopic pericardial fenestration: diagnostic and therapeutic aspects.

A Cantó, R Guijarro, A Arnau, A Fernández-Centeno, M A Císcar, J Galbis, A García-Vilanova

Thoracic Surgery Unit, Valencia University General Hospital, Spain.

The cause of cardiac tamponade is only established in 50% of cases. This problem is most commonly treated by pericardiocentesis alone, pericardiotomy being reserved for cases of recurrence and pericardiectomy for those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscope is presented. Pericardial and pleural biopsies were performed, together with cytological and biochemical analysis of the pericardial and pleural fluid where present. This procedure established the aetiology of effusion in all cases. In malignant pericardial effusion bleomycin was used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%).

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Kamata, Y, Iwamoto, M, Aoki, Y, Kishaba, Y, Nagashima, T, Nara, H, Kamimura, T, Tanaka, A, Yoshio, T, Okazaki, H, Minota, S (2008). Massive intractable pericardial effusion in a patient with systemic lupus erythematosus treated successfully with pericardial fenestration alone. Lupus 17: 1033-1035 [Abstract]  
• Georghiou, G. P., Stamler, A., Sharoni, E., Fichman-Horn, S., Berman, M., Vidne, B. A., Saute, M. (2005). Video-Assisted Thoracoscopic Pericardial Window for Diagnosis and Management of Pericardial Effusions. Ann. Thorac. Surg. 80: 607-610 [Abstract] [Full Text]  
• Tsang, T. S. M., Enriquez-Sarano, M., Freeman, W. K., Barnes, M. E., Sinak, L. J., Gersh, B. J., Bailey, K. R., Seward, J. B. (2002). Consecutive 1127 Therapeutic Echocardiographically Guided Pericardiocenteses: Clinical Profile, Practice Patterns, and Outcomes Spanning 21 Years. Mayo Clin Proc. 77: 429-436 [Abstract]  
• Geissbuhler, K., Leiser, A., Fuhrer, J., Ris, H.-B. (1999). Video-assisted thoracoscopic pericardial fenestration for loculated or recurrent effusions. Eur. J. Cardiothorac. Surg. 14: 403-408 [Abstract] [Full Text]  
• Maher, E. A., Shepherd, F. A., Todd, T. J. R. (1996). PERICARDIAL SCLEROSIS AS THE PRIMARY MANAGEMENT OF MALIGNANT PERICARDIAL EFFUSION AND CARDIAC TAMPONADE. J. Thorac. Cardiovasc. Surg. 112: 637-643 [Abstract] [Full Text]