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.