Subxiphoid Tube Pericardiostomy in the Management of Pericardial Effusion: Our Experience

Abstract

Introduction -There is minimal amount of fluid within the two layers of the pericardium. This serves to lubricate the layers preventing friction. Various disease processes can lead to increase in the amount of this fluid which cause haemodynamic compromise these patients. Various methods have been used to drain this fluid. We report our experience with subxiphoid tube pericardiotomy in the drainage of pericardial effusion. Material and Method -we reviewed case files of 30 patients that presented to us with pericardial effusion over a six-year period. Results -There were 19 males (63.3%) and 11 females (36.7%). Age range is between 2 yrs and 65 years with a mean of 27.3 yrs. Adult age group accounted for 25 (83.3%) while paediatric age group was 5 (16.7%). Predominant symptom was dyspnea and all patients had subxiphoid tube pericardiostomy for drainage. Majority of our patients (80%) had tuberculosis as the cause of their effusion. Mortality was 3 (10%) following the drainage but cause of death was progression of their disease. The was recurrence in one patient who had malignant effusion and was subsequently treated with pericardial window but later lost to follow up. Conclusion -Subxiphoid tube pericardiostomy still remains the main stay in the management of massive tuberculous pericardial effusion in our environment as it provides the opportunity to drain the fluid and take adequate fluid samples and tissue for diagnosis. Recurrence rate is also low.