ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Subxiphoid pericardial window and percutaneous catheter drainage for treatment of cardiac tamponade
Gökhan Önem1, Ahmet Baltalarlı1, A. Vefa Özcan1, Harun Evrengül2, İbrahim Gökşin1, Mustafa Saçar1, Oya Rendeci1, Fahri Adalı1
1Pamukkale Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Denizli
2Pamukkale Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Denizli
Background: The outcomes of subxiphoid pericardial window and percutaneous catheter drainage techniques were compared in patients with cardiac tamponade.

Methods: Thirty three patients with cardiac tamponade (19 men, 14 women; mean age 45.4; range 13 to 68 years) were treated with either subxiphoid pericardial window (n=21) or percutaneous catheter drainage (n=12) between May 1998 and September 2004. The two techniques were compared in terms of mortality, complication and recurrence rates.

Results: No operative deaths or complications were observed in patients treated with the subxiphoid pericardial window technique. In contrast, percutaneous catheter drainage was associated with significantly higher mortality (8.3%) and complication rates (16.6%). Symptomatic recurrence of pericardial effusion after percutaneous catheter drainage occurred in 3 (25%) out of 12 patients, However, the overall effusion recurrence rate among patients undergoing subxiphoid pericardial window was 4.8% (1 out of 21) (p<0.05).

Conclusion: Subxiphoid pericardial window is a safe and effective technique for management of cardiac tamponade. Percutaneous catheter drainage should be reserved for patients with hemodynamic instability.

Keywords : Cardiac tamponade/surgery; drainage/instrumentation; pericardiectomy/instrumentation
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