Video-Assisted Pericardial Fenestration for Effusions after Cardiac Surgery

2009 ◽  
Vol 17 (5) ◽  
pp. 480-482 ◽  
Author(s):  
Georgios P Georghiou ◽  
Eyal Porat ◽  
Avi Fuks ◽  
Bernardo A Vidne ◽  
Milton Saute
Keyword(s):  
Cardiac Surgery ◽  
Pericardial Effusion ◽  
Surgical Techniques ◽  
Lung Ventilation ◽  
Pericardial Window ◽  
Invasive Approach ◽  
Video Assisted ◽  
Institutional Experience ◽  
Pericardial Fenestration ◽  
Thoracoscopic Technique

Delayed-onset pericardial effusion following cardiac surgery can give rise to significant morbidity due to its presentation as well as management by traditional surgical techniques. An institutional experience of a video-assisted thoracoscopic technique to create a pericardial window, with the advantages of a minimally invasive approach combined with excellent visualization in such patients, was reviewed. A retrospective analysis was conducted on all patients undergoing video-assisted thoracoscopic for delayed pericardial effusion after cardiac surgery from January 2001 to January 2006 at our center. Seven patients with echocardiographically diagnosed delayed tamponade underwent video-assisted thoracoscopy; 5 were receiving anticoagulants after valve replacement, and 2 had undergone heart transplantation. Pericardial windows were created under general anesthesia and single-lung ventilation using 2 to 3 trocars. Mean operative time was 45 min. There were no complications of the thoracoscopic technique. Video-assisted thoracoscopic creation of a pericardial window is safe and effective treatment for loculated pericardial effusions secondary to cardiac surgery.

scholarly journals Survival Following Video-Assisted Thoracic and Mini-Thoracotomy Pericardial Fenestration

2018 ◽  
Vol 103 (3-4) ◽  
pp. 222-226
Author(s):  
Wolfgang G. Mouton ◽  
Joana Mürmann ◽  
Kim T. Mouton
Keyword(s):  
Blood Pressure ◽  
Surgical Techniques ◽  
Underlying Disease ◽  
The Other ◽  
Shock Index ◽  
Video Assisted ◽  
Ventricular Puncture ◽  
Pericardial Fenestration ◽  
Mini Thoracotomy ◽  
Related Mortality

Objective: Surgical pericardial fenestration (sPF) is more invasive than interventional pericardiocentesis (PC) and requires general anesthesia. Severe complications such as ventricular puncture and chamber lacerations are, however, reported in association with PC and not with sPF. Is survival after sPF only determined by nonsurgical factors? Methods: Between July 2000 and December 2015, data of all patients who had undergone sPF—either thoracoscopically or by anterior mini-thoracotomy—were investigated. The 2 techniques were analyzed retrospectively and the outcome (effectiveness, change in shock index) and the survival were assessed. Results: 32 patients underwent 33 sPF. One-half of the patients had a benign underlying disease; the other half suffered from a malignant tumor. Four procedures were performed thoracoscopically and 29 via mini-thoracotomy. Both techniques were hemodynamically effective (P < 0.0001) in increasing blood pressure and decreasing pulse rate). There was no death due to failure to control the pericardial effusion and no procedure related mortality. Of the 16 patients with benign underlying disease 14 (87.5%) are still alive. Two died due to reasons unrelated to the procedure or the underlying disease. All 16 patients (100%) with malignant underlying disease died due to tumor progression. Conclusions: In our patient cohort minimally invasive thoracic PF was safe and effective. The survival in our study was only related to the nature of the underlying disease. We conclude that sPF is an excellent procedure to treat pericardial effusions: both examined surgical techniques, thoracoscopic video assisted and access via mini-thoracotomy, were equally effective and safe.

Video-assisted thoracoscopic pericardial fenestration for tuberculous pericardial effusion

2004 ◽  
Vol 52 (2) ◽  
pp. 68-70 ◽  
Author(s):  
Kotaro Kameyama ◽  
Cheng-long Huang ◽  
Taku Okamoto ◽  
Shinya Ishikawa ◽  
Yasumichi Yamamoto ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Video Assisted ◽  
Pericardial Fenestration

scholarly journals Video-assisted thoracoscopic pericardial window for massive pericardial effusion: South Egypt experience

2017 ◽  
Vol 25 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Mohamed Abdel Bary ◽  
Khaled M. Abdel-aal ◽  
Ramadan Gh. Mohamed ◽  
Ahmad M. Abdel-maboud ◽  
Abdelhadi A. Helmy
Keyword(s):  
Pericardial Effusion ◽  
Pericardial Window ◽  
Video Assisted

scholarly journals Incarcerated intrapericardial diaphragmatic hernia after laparoscopic pericardial window for malignant pericardial effusion

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Ekhlas S Bardisi ◽  
◽  
Luning Redmer ◽  
Luk Verlaeckt ◽  
Filip Vanrykel ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Diaphragmatic Hernia ◽  
Lung Ventilation ◽  
Pericardial Tamponade ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion ◽  
Minimally Invasive Surgical ◽  
Thoracic Drainage ◽  
Treatment Measures ◽  
Intrapericardial Diaphragmatic Hernia

Laparoscopic Pericardial Window (LPW) is a safe, minimally invasive surgical technique for treating pericardial effusion/tamponade. This technique allows adequate decompression and avoids single-lung ventilation and the need for thoracic drainage in severely ill patients; it also provides anatomopathological and microbiological diagnosis leading to treatment measures. An intrapericardial diaphragmatic hernia is among the rarest complications of this procedure. A 85-year-old man, who underwent LPW for pericardial tamponade, presented to the emergency department 12 days post-operative with bowel obstruction; CT scan showed an incarcerated hernia into the pericardial sac. Laparoscopic reduction and hernia repair were performed using a large-pore Mesh to allow further drainage of histologically proven malignant pericardial effusion. Keywords: pericardial tamponade; pericardial window; surgical drainage of pericardial effusion; intra-pericardial diaphragmatic hernia.

Video-Assisted Thoracoscopy Yonsei University Experience

1995 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
Lee Doo Yun ◽  
Kim Hae Kyoon ◽  
Paik Hyo Chae
Keyword(s):  
Mediastinal Mass ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Early Recovery ◽  
Pericardial Window ◽  
Video Assisted ◽  
Lower Complication ◽  
Lung Biopsies ◽  
University Experience ◽  
Thoracotomy Incision

Video-assisted thoracoscopy (VAT) is a new modality that allows visualization and access to the intrathoracic organs without performing posterolateral thoracotomy incision. Recent advancements in endoscopic equipment and surgical techniques have expanded the applications of VAT in thoracic surgery. We performed 171 VAT cases, which previously would have been performed through thoracotomy incisions in 116 patients. The operations performed included 3 wedge resections of the pulmonary nodule, 14 pleural or lung biopsies, 1 pericardial window formation, 93 sympathectomies, 40 bullectomies and pleurodeses, 16 biopsies or excisions of mediastinal mass, and 4 lobectomies. Patients who received operation by VAT seemed to have much less postoperative pain and lower complication rates allowing early recovery and shorter hospitalization.

Single-Port Thoracoscopic Pericardial Window under Local Anesthesia

2018 ◽  
Vol 13 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Chang Y. Park ◽  
Niall C. McGonigle
Keyword(s):  
Pericardial Effusion ◽  
Single Port ◽  
Metastatic Breast ◽  
Careful Consideration ◽  
Surgical Approaches ◽  
General Anesthetic ◽  
Best Interest ◽  
Pericardial Window ◽  
Left Hemithorax ◽  
Invasive Approach

There are numerous surgical approaches for the treatment of pericardial effusions but no clear consensus of best management. We present a 44-year-old woman with metastatic breast cancer presenting with a new 2-cm pericardial effusion on ultrasound. In light of the patient's palliative condition and the urgent need for chemotherapy, careful consideration was made for her surgical drainage of the pericardial effusion. Because of the patient's medical comorbidities, a general anesthetic was deemed not to be in the patient's best interest. Furthermore, the invasive subxiphoid or thoracotomy approach for a pericardial window would have risked delaying her much needed chemotherapy. A single-port thoracoscopic pericardial window was performed under light sedation, ventilating spontaneously on supplementary oxygen through nasal cannula only. The patient was positioned in a supine position, and a single 8-mm port was inserted into the left hemithorax at the 5th intercostal space, midaxillary line under local anesthetic, and a pericardial window made. This minimally invasive approach, without the need for intubation or ventilation, allowed for rapid relief of symptoms and discharge for the patient to begin her chemotherapy in a timely manner. By undergoing the procedure awake and through a single port, the patient was discharged after a short inpatient stay. This novel approach can be advocated for patients where a general anesthetic or invasive surgical procedure is not suitable in the treatment of their pericardial effusion.

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