scholarly journals Subxiphoid window drainage of pericardial effusion - study of 35 cases

1970 ◽  
Vol 5 (2) ◽  
pp. 71-74 ◽  
Author(s):  
Rezwanul Hoque ◽  
Mostafa Nuruzzaman ◽  
Sabrina Sharmin Husain ◽  
Zerzina Rahman
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Exclusion Criteria ◽  
Pericardial Window ◽  
Echocardiographic Finding ◽  
Malignant Pericardial Effusion ◽  
Physical Findings ◽  
Age Range ◽  
Effusive Constrictive Pericarditis ◽  
Video Assisted Thoracoscopic Surgery

Pericardial effusion defines the presence of an abnormal amount and/or character of fluid in the pericardial space. It can be acute or chronic and caused by a variety of local and systemic disorders, or it may be idiopathic. Pericardial effusion can be relieved by medical treatment, pericardiocentesis through a needle with or without echocardiographic guidance, or by surgical procedures, such as subxiphoid pericardial tube drainage, by creating a pericardial window through a left anterior thoracotomy, or by video assisted thoracoscopic surgery (VATS) Subxiphoid pericardial window drainages were done on 35 patients with symptomatic pericardial effusion in the Department of cardiac surgery, BSMMU, from February, 1995 through July, 2009, and were all included in this retrospective observational study. The inclusion criteria were an established diagnosis of pericardial effusion confirmed by history, physical findings and transthoracic echocardiography, hemodynamic alteration as evidenced by hypotension( systolic blood pressure < 90 mm of Hg), shortness of breath, echocardiographic finding of > 10 mm echo free space with/ without compression of heart, recurrence after pericardiocentesis, haemorrhagic or thick pericardial effusion and malignant pericardial effusion. The exclusion criteria were loculated or post surgical pericardial effusion, effusive constrictive pericarditis or where formal thoracotomy was applied for drainage of effusion. Patients were followed up at one month and three months following the drainage procedure. The age range was from 13 years to 70 years (Mean 47.86 ± SD 15.20 years), 19 (54.28%) were male, 16(45.72%) were female. The symptomatology varied but cardiac and respiratory decompression overwhelmed other symptoms. In this study tuberculosis is the most common cause of pericardial effusion, idiopathic and malignancies are other important causes. Subxiphoid window drainage is an effective process in relieving pericardial effusion and the reaccumulation rate is low. Key words: Subxiphoid window drainage; Surgical drainage of pericardial effusion; Pericardial effusion. DOI: 10.3329/uhj.v5i2.4558 University Heart Journal Vol.5(2) July 2009 pp.71-74

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Uniportal video-assisted thoracoscopic surgery pericardial window

2006 ◽  
Vol 131 (4) ◽  
pp. 921-922 ◽  
Author(s):  
Gaetano Rocco ◽  
Antonello La Rocca ◽  
Carmine La Manna ◽  
Francesco Scognamiglio ◽  
Massimiliano D’Aiuto ◽  
...  
Keyword(s):  
Thoracoscopic Surgery ◽  
Pericardial Window ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals 1095 Effective image-guided medical management in effusive constrictive pericarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Montes ◽  
A Cecconi ◽  
T Alvarado ◽  
A Vera ◽  
A Barrios ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Medical Treatment ◽  
Constrictive Pericarditis ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Intravenous Corticosteroid ◽  
Persistent Inflammation ◽  
High Doses ◽  
Effusive Constrictive Pericarditis

Abstract A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started. During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition. Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D). Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis. Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery. Abstract 1095 Figure.

QS7. Using Apache® III-J to Predict Outcome in Patients Undergoing Pericardial Window for Malignant Pericardial Effusion

2008 ◽  
Vol 144 (2) ◽  
pp. 273
Author(s):  
Faiz Y. Bhora ◽  
Daniel Sagalovich ◽  
M. Jawad Latif ◽  
John Afthinos ◽  
Cliff P. Connery
Keyword(s):  
Pericardial Effusion ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion

Malignant pericardial effusion with cardiac tamponade in a patient with metastatic vaginal adenocarcinoma

2006 ◽  
Vol 16 (3) ◽  
pp. 1458-1461 ◽  
Author(s):  
N. P. Nagarsheth ◽  
M. Harrison ◽  
T. Kalir ◽  
J. Rahaman
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Lung Metastases ◽  
Gynecological Cancer ◽  
Disease Process ◽  
Surgical Excision ◽  
Clear Cell Adenocarcinoma ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion ◽  
Platinum Based Chemotherapy

Malignant pericardial effusion with cardiac tamponade is a rare manifestation of metastatic gynecological cancer. A 35-year-old female was diagnosed with clear cell adenocarcinoma of the vagina. Four years after partial vaginectomy, she developed regional recurrence and was treated with surgical excision followed by platinum-based chemotherapy and radiation therapy. Six years later, the patient was diagnosed with lung metastases and received a combination adriamycin and platinum-based chemotherapy. Shortly after completing treatment, she presented with weakness and was found to be hypotensive on physical exam. Computed tomography scan confirmed a pericardial effusion with evidence of bilateral heart failure. She underwent an emergent pericardiocentesis and eventual pericardial window procedure. Metastatic adenocarcinoma of the vagina can present with malignant pericardial effusion with cardiac tamponade. Therefore, gynecologists and gynecological oncologists need to be familiar with the diagnosis and management of this disease process.

scholarly journals Cardiac tamponade due to malignant pericardial effusion in breast cancer: A case report

2016 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sultan Mahmud ◽  
Omar Sadeque Khan ◽  
Md. Aftabuddin ◽  
Asit Baran Adhikary
Keyword(s):  
Breast Cancer ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Duct Cell ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Severe Respiratory Distress ◽  
Malignant Pericardial Effusion ◽  
History Of ◽  
Subxiphoid Pericardial Window

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examina­tion confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate sympto­matic relief was observed.

Subxiphoidal pericardial ‘window’ in the management of malignant pericardial effusion

1995 ◽  
Vol 21 (5) ◽  
pp. 545-547 ◽  
Author(s):  
P.P. Vassilopoulos ◽  
K. Nikolaidis ◽  
E. Filopoulos ◽  
J. Griniatsos ◽  
A. Efremidou
Keyword(s):  
Pericardial Effusion ◽  
Pericardial Window ◽  
Malignant Pericardial Effusion

scholarly journals Diagnosis and treatment of effusive–constrictive pericarditis: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Yousif Al-Saiegh ◽  
Jenna Spears ◽  
Tim Barry ◽  
Christopher Lee ◽  
Howard Haber ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Sleep Apnoea ◽  
Therapeutic Interventions ◽  
Right Atrial ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Obstructive Sleep ◽  
Obesity Hypertension ◽  
Effusive Constrictive Pericarditis

Abstract Background Effusive–constrictive pericarditis (ECP) is a rare syndrome involving pericardial effusion and concomitant constrictive pericarditis. The hallmark is a persistently elevated right atrial pressure of &gt;10 mmHg or reduction of less than 50% from baseline despite pericardiocentesis. Aetiologies include radiation, infection, malignancy, and autoimmune disease. Case summary A 71-year-old man with a history of atrial fibrillation, obesity, hypertension, obstructive sleep apnoea, managed with continuous positive airway pressure presented with acute pericarditis complicated by pericardial effusion leading to cardiac tamponade. He was diagnosed with ECP after pericardiocentesis and was managed surgically with a pericardial window. Discussion Early detected cases of ECP can be managed by medical therapy. Therapeutic interventions include pericardiocentesis, balloon pericardiostomy, and pericardiectomy. This report describes a case of new-onset congestive heart failure secondary to ECP.

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