Management of pericardial effusion by subxiphoidal pericardiostomy in adults

Volkan Yüksel; Serhat Hüseyin; Ahmet Okyay; Selami Cem Gürkan; Özcan Gür; Suat Canbaz; Enver Duran

doi:10.5606/tgkdc.dergisi.2012.095

Volkan Yüksel¹, Serhat Hüseyin¹, Ahmet Okyay¹, Selami Cem Gürkan², Özcan Gür², Suat Canbaz¹, Enver Duran¹

¹Department of Cardiovascular Surgery, Medical Faculty of Trakya University, Edirne, Turkey
²Department of Cardiovascular Surgery, Medical Faculty of Namık Kemal University, Tekirdağ, Turkey

DOI : 10.5606/tgkdc.dergisi.2012.095

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.

Keywords : Etiology; pericardial effusion; pericardial tube drainage; subxiphoidal pericardiostomy

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