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Ann Thorac Surg 1989;48:381-385
© 1989 The Society of Thoracic Surgeons

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Articles

Clinical Experience With Subxiphoid Drainage of Pericardial Effusions

Division of Thoracic and Cardiovascular Surgery, University of Miami School of Medicine, Miami, Florida

Accepted for publication May 26, 1989.

^* Address reprint requests to Dr Palatianos, Division of Thoracic and Cardiovascular Surgery (R-114), University of Miami School of Medicine, PO Box 016960, Miami, FL 33101
^** Dr Pompeo's present address is Department of Surgery, Southwestern Medical Center, Dallas, TX 75235-9005

To assess the effectiveness of subxiphoid pericardial tube drainage for treatment of pericardial effusion, we reviewed 41 consecutive patients who underwent this procedure during a 14-year period. The patients ranged in age from 7 months to 75 years. All were symptomatic preoperatively. The diagnosis of pericardial effusion was confirmed by echocardiogram in all but 2 patients. Eight patients had acute pericardial tamponade. Subxiphoid pericardial drainage was performed under general (n = 35) or local anesthesia (n = 6). A portion of the anterior pericardium was excised in each patient. There were no perioperative deaths. Thirty-day mortality was 19.5%; there were five late deaths. All deaths were unrelated to pericardial effusion or to the operation. One patient had recurrent effusion requiring pericardiocentesis on the 21st postoperative day. He died five days later of extensive lymphoma. Twenty-eight patients were followed from 1 month to 10 years; mean follow-up was 31.5 months. None developed recurrent effusion or pericardial constriction. We conclude that subxiphoid pericardial drainage is effective for treatment of pericardial effusion.

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