Original article: cardiovascularComparison of open subxiphoid pericardial drainage with percutaneous catheter drainage for symptomatic pericardial effusion
Section snippets
Patients
From January 1995 to December 1999, 246 patients with clinical and echocardiographic evidence of tamponade underwent treatment of their effusion at Barnes-Jewish Hospital in St. Louis, Missouri. This retrospective study was reviewed and approved by the Washington University Human Studies Committee (HSC #00-1118, 1/10/01). The choice of procedure was determined in many cases by the cardiologist performing the echocardiogram. If the echocardiogram suggested that the effusion was mostly posterior
Results
Two hundred forty-six patients underwent 271 procedures. Two hundred twenty-four patients underwent one procedure, 20 underwent two procedures, and one each underwent three and four procedures. One hundred thirty patients were female (53%), and 116 were male (47%), with age ranging from 16 to 91 years and a mean of 56 years. Patient characteristics, treatment characteristics, and etiology by treatment group is shown in Table 2. Etiology was presumed to be malignant if an underlying malignancy
Comment
Symptomatic pericardial effusions occur as a result of multiple disease processes and can be treated with many different procedures. For this reason, the optimal procedure for treatment of these effusions remains controversial. The ideal procedure would be easy to perform, result in minimal morbidity and mortality, have infrequent recurrences, and allow for diagnosis of the cause of the effusion if malignant. The two primary modalities utilized to drain symptomatic pericardial effusions have
Discussion
DR JOSEPH I. MILLER (Atlanta, GA): I very much enjoyed your presentation. I would just raise two potential questions. First, in your patients with malignant pericardial effusion, were the majority of these from lung cancer or were they from other causes?
Second, we have done the same thing you have done in utilizing the subxiphoid approach, particularly for lung cancer; however, when there has been a malignant effusion from breast cancer, lymphoma, or leukemia, we have used a limited parietal
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Recurrence of pericardial effusion after different procedure modalities in patients with non-small-cell lung cancer
2022, ESMO OpenCitation Excerpt :These paramalignant etiologies include pericardial effusion due to inflammation, lymphatic or venous drainage obstruction, or treatment-related effusion.8-13 Intervention procedures are crucial steps for preventing death due to pericardial tamponade, and different procedures show varying success rates, safety, and pericardial effusion recurrence rates.14-27 Nowadays, simple pericardiocentesis, balloon pericardiotomy, or surgical pericardiectomy are often carried out on patients harboring symptomatic pericardial effusion.
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