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Ann Thorac Surg 2003;76:817-820
© 2003 The Society of Thoracic Surgeons

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Original article: cardiovascular

Pericardiocentesis with extended catheter drainage: an effective therapy

^a Department of Surgery, St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA
^b Department of Surgery, Foote Hospital, Jackson, Michigan, USA

Accepted for publication March 27, 2003.

^* Address reprint requests to Dr Lampman, St. Joseph Mercy Hospital, P.O. Box 995, 5333 McAuley Dr, Reichert Health Building, Suite 2111, Ann Arbor, MI 48106, USA.
e-mail: lampmanr{at}trinity-health.org

BACKGROUND: The most effective method for managing pericardial effusions has yet to be identified. This study evaluates the efficacy and safety of echocardiographic-guided placement of indwelling catheters into the pericardial space.

METHODS: This study consists of a 5-year retrospective chart review of consecutive patients coded with benign or malignant pericardial effusions who presented for drainage procedures to a single surgeon at a 260-bed hospital. Complication, recurrence, and survival rates were studied.

RESULTS: Between January 1996 and August 2001, a total of 29 pericardial drainage procedures were performed; eight of those also underwent talc sclerosis. Mean follow-up was 16 months. Three patients (10%) required conversion to thoracotomy; of those remaining, 25 of the 26 procedures were performed under local anesthesia with intravenous sedation. The identified etiologies for pericardial effusions were malignancy (76%), idiopathic (14%), postcoronary artery bypass grafting procedure (3%), viral pericarditis (3%), and uremia (3%). Echocardiographic features of tamponade were documented in 72%. Mean ± SEM length of postprocedure in-hospital stay was 6.7 ± 0.82 days. The overall complication rate was 10% (pneumothorax and cardiac injury). Recurrence rate within 30 days was 7%. Thirty-day mortality was 21%, and more than 90-day survival was 72%.

CONCLUSIONS: Pericardiocentesis with extended catheter drainage is a safe treatment for management of clinically significant, malignant and benign, pericardial effusions and can be performed effectively under local anesthesia with intravenous sedation.

This article has been cited by other articles:

				N Becit, Y Unlu, M Ceviz, C U Kocogullari, H Kocak, and Y Gurlertop Subxiphoid pericardiostomy in the management of pericardial effusions: case series analysis of 368 patients Heart, June 1, 2005; 91(6): 785 - 790. [Abstract] [Full Text] [PDF]

				C. L. Buchanan, V. V. Sullivan, R. Lampman, and M. G. Kulkarni Reply Ann. Thorac. Surg., January 1, 2005; 79(1): 387 - 387. [Full Text] [PDF]

				K. B. Allen Subxiphoid Pericardiostomy Versus Percutaneous Extended Catheter Drainage Ann. Thorac. Surg., January 1, 2005; 79(1): 386 - 387. [Full Text] [PDF]