The pericardial window: is a video-assisted thoracoscopy approach better than a surgical approach?

Muhammad, Magdi Ibrahim Ahmad

doi:10.1510/icvts.2010.243725

Cited by 39 publications

(30 citation statements)

References 23 publications

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“…They reported the recurrence rate of pericardial effusion to be 8% after VATS. In a prospective study [12] including 30 patients, of which 15 (10 with tamponade) underwent VATS and 15 (seven with tamponade) underwent surgical procedure (transthoracic or subxiphoid), no significant difference was found in terms of intra- or postoperative complications, mortality, duration of drainage, duration of hospitalization, and recurrence; however, operative time was reported to be significantly longer in those undergoing VATS. [Becit et al] reported a recurrence rate of 10% within 1 month of subxiphoid surgical pericardiostomy in 368 patients with pericardial effusions (most of them had pericarditis associated with tuberculosis and uremia) and they created a pericardial window by left anterior thoracotomy in these patients with no subsequent recurrence.…”

Section: Discussionmentioning

confidence: 99%

Surgical properties and survival of a pericardial window via left minithoracotomy for benign and malignant pericardial tamponade in cancer patients

et al. 2012

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BackgroundSurgical drainage is a rapid and effective treatment for pericardial tamponade in cancer patients. We aimed to investigate the effectiveness of pericardial window formation via mini-thoracotomy for treating pericardial tamponade in cancer patients, and to evaluate clinical factors affecting long-term survival.MethodsRecords of 53 cancer patients with pericardial tamponade treated by pericardial window formation between 2002 and 2008 were examined. Five patients were excluded due to insufficient data. Kaplan-Meier and Cox regression analysis were used for analysis.ResultsForty-eight patients (64.7% male), with a mean age of 55.20 ± 12.97 years were included. Patients were followed up until the last control visit or death. There was no surgery-related mortality and the 30-day mortality rate was 8.33%; all died during postoperative hospitalization. Morbidity rate was 18.75%. Symptomatic recurrence rate was 2.08%. Cancer type and nature of the pericardial effusion were the major factors determining long-term survival (P <0.001 and P <0.004, respectively).Overall median survival was 10.41 ± 1.79 months. One- and 2-year survival rates were 45 ± 7% and 18 ± 5%, respectively.ConclusionPericardial window creation via minithoracotomy was proven to be a safe and effective approach in surgical treatment of pericardial tamponade in cancer patients. Cancer type and nature of pericardial effusion were the main factors affecting long-term survival.

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Section: Discussionmentioning

confidence: 99%

Surgical properties and survival of a pericardial window via left minithoracotomy for benign and malignant pericardial tamponade in cancer patients

et al. 2012

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“…However, it requires general anesthesia and single-lung ventilation which are difficult to perform on critically ill patients. [13] Pericardiocentesis was not used electively as a diagnostic and therapeutic modality on our patients. It has incomplete diagnostic effectiveness in patients with tuberculous pericarditis and malignant processes invading the pericardium because a sufficient pericardial biopsy specimen cannot be taken.…”

Section: Discussionmentioning

confidence: 98%

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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“…VATS is increasingly being accepted as the approach of choice over open techniques 2 . The advantages of using 3‐mm needlescopic access and instruments over conventional 10–15‐mm VATS access remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…VATS is increasingly being accepted as the approach of choice over open techniques. 2 The advantages of using 3-mm needlescopic access and instruments over conventional 10-15-mm VATS access remain unclear. A recent trial comparing nVATS sympathectomy with standard VATS showed no significant difference in the incidence of postoperative paraesthesia up to a follow up of 40 months between the groups.…”

Section: Discussionmentioning

confidence: 99%