Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage

Allen, Keith B.; Faber, L. Penfield; Warren, William H.; Shaar, Carl J.

doi:10.1016/s0003-4975(98)01192-8

Cited by 133 publications

(79 citation statements)

References 23 publications

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“…Extended catheter drainage after pericardiocentesis, percutaneous balloon pericardiotomy, and various other surgical approaches are also possible options to prevent recurrence. They have been compared, with inconsistent results, in many retrospective studies [7][8][9][10][11] . Recently, a retrospective analysis in 88 patients showed that, compared with surgical pericardiotomy, pericardiocentesis with extended drainage had the same diagnostic yield, the same recurrence rate, and fewer complications 12 ; and a systematic review including 1399 patients concluded that surgical drainage is superior to nonsurgical approaches in terms of symptom relief, effusion recurrence, and morbidity 13 .…”

Section: Introductionmentioning

confidence: 99%

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

2015

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Section: Introductionmentioning

confidence: 99%

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

2015

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“…Allen reported a series of 117 patients with cardiac tamponade resulting from PE. [14] The mortality rate in 94 patients who underwent a subxiphoid pericardiostomy was 0%, the complication rate was 1.1% (1/94), and the recurrence rate was 1.1% (1/94). Conversely, in 23 patients with PE who underwent echo-guided percutaneous catheter drainage performed by a cardiologist, the mortality rate was 4.3% (1/23), the complication rate was 17% (4/23), and the recurrence rate was 32% (7/22).…”

Section: Discussionmentioning

confidence: 92%

Management of pericardial effusion by subxiphoidal pericardiostomy in adults

Yüksel¹,

Chousein-Hüseyin²,

Okyay³

et al. 2012

Turk Gogus Kalp Dama

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Background:We aimed to assess the effectiveness of subxiphoid pericardiostomies in the treatment of patients with pericardial effusion (PE) and to discuss the etiology for this patient population. Methods: Between January 2004 and January 2011, 148 patients (77 males, 71 females; mean age 60.1±12.3 years; range 34 to 89 years;) who underwent a subxiphoid pericardiostomy and tube drainage due to a diagnosis of PE were retrospectively analyzed. Results: Echocardiography classified PE as severe in 36 patients, moderate in 68, and mild in 44. The main causes of PE were uremia and malignancy along with idiopathic and undefined tuberculous and non-tuberculous pericarditis. A perioperative myocardial injury requiring a sternotomy occurred in two patients. A histopathological examination contributed to the diagnosis in 84.3% of the patients with malignancy. The overall 30-day mortality rate was 7% (n=11). Pericardial constriction requiring a pericardiectomy developed in two patients. Conclusion: Pericardial effusion can be an effective and quick method for managing adults with subxiphoid pericardiostomy.

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“…13 14 Furthermore, the procedure does not include visualisation or biopsy of the pericardium. 13 In a series of 63 patients with cardiac tamponade undergoing primary pericardiocentesis, Bastian and colleagues 14 reported a success rate of 81% and a recurrence rate of 19%. In a similar study, Vayre and colleagues 15 reported a major complication incidence of 10%, and emergency surgical drainage was required for a failed procedure in 4% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Allen and colleagues 13 reported on a series of 117 patients with cardiac tamponade resulting from pericardial effusion. The mortality in 94 patients who underwent subxiphoid pericardiostomy was 0%, the complication rate was 1.1% (one of 94), and the recurrence rate was 1.1% (one of 94).…”

Section: Discussionmentioning

confidence: 99%

Severe mitral regurgitation caused by annular abscess fistulating into the left atrium

Ps¹

2005

Heart

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Objective: To assess the effectiveness of subxiphoid pericardiostomy in the treatment and diagnosis of pericardial effusions. Methods: 368 patients who underwent subxiphoid pericardiostomy and tube drainage for cardiac tamponade, moderate to severe pericardial effusion, or suspicious bacterial aetiology were retrospectively analysed. Biopsies of the pericardium and fluid samples for diagnostic tests were obtained from each patient. Results: The mean age of the patients was 38.4 years, and the male to female ratio was 220:148. The pericardial effusion was classified by echocardiography as severe in 53% of the patients, moderate in 43%, and mild in 4%. The incidence of cardiac tamponade was 25%. Myocardial injury requiring sternotomy occurred as an operative complication in 0.8% of the patients and recurrent effusion necessitating further surgical intervention developed in 10% of patients. Histopathological examination and the polymerase chain reaction of specimens of pericardium and fluid were helpful for establishing a diagnosis in 90% of patients with malignancy and 92% of patients with tuberculous pericarditis. The overall 30 day mortality rate was 0.8%. Patients were followed up for at least one year. Pericardial constriction requiring pericardiectomy developed in 3% of the patients. Conclusions: Pericardial effusions of various causes can be safely, effectively, and quickly managed with subxiphoid pericardiostomy in both adults and children.

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Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage

Cited by 133 publications

References 23 publications

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

Pericardiocentesis versus Pericardiotomy for Malignant Pericardial Effusion: A Retrospective Comparison

Management of pericardial effusion by subxiphoidal pericardiostomy in adults

Severe mitral regurgitation caused by annular abscess fistulating into the left atrium

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