ABSTRACT

Aim

Pericardium is a tough double layered membrane which covers the heart. Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. If the effusion is compromising heart function and causing cardiac tamponade, it needs to be drained. In our study we aimed to compare pericardiopulmonary window and anterior subxiphoidal pericardiostomy techniques.

Materials and Methods

In this retrospective study pericardiopulmonary window and anterior pericardiostomy techniques were compared. In pericardiopulmonary window group, pericardium was opened via a left mini anterothoracotomy through the fourth intercostal area using a mini sternal retractor and pericardium was resected (approximately 4x6 cm), In pericardiostomy group pericardium was exposed via subxiphoidal approach and chest drainage tube was inserted by mini anterior incision. 28 F drainage tubes were used for drainage in all patients. The drainage tube was removed when amount of daily drainage was below 150 ml.

Results

A total of 18 patients underwent an initial drainage procedure for a pericardial effusion. The mean age of the patients were 56.25±9.27 years (range, 45–83 years). 6 (33.3%) were female and 12 (66.6%) were male. On 10th postoperative day one patient died due to cerebrovascular accident (%11.1) in pericardiopulmonary window group. Reoperation was required in two patients in subxiphoidal pericardiostomy group for reccurence of pericardial effusion one month later (%22.2).

Conclusion

The choice of surgical technique for pericardial effusion is very important. We think that, while pericardiopulmonary window technique is suitable for patients with recurrent pericardial effusion, subxiphoidal pericardiostomy technique is suitable for other situations.