Pericardotomy

To present an alternative percutaneous technique to surgery for the treatment of recurrent malignant pericardial effusion

Percutaneous pericardiotomy in malignant pericardial effusion

Purpose: To present an alternative percutaneous technique to surgery for the treatment of recurrent malignant pericardial effusion.

Methods and Materials: Three patients with disseminated bronchopulmonary neoplasm and malignant pericardial effusion with severe hemodynamic repercussion are presented. A percutaneous pericardiotomy was performed under mild sedation and local anesthesia. After a subphrenic puncture of the pericardial space, with ultrasonographic guidance, a balloon angioplasty catheter (18 mm diameter) was introduced and subsequently inflated in the pericardial wall until the disappearance of the waist. A 7 Fr pigtail catheter was left for drainage and afterwards extracted three days later.

Results: The procedures were performed without complications. Sequential ultrasound studies performed during the follow-up of the patients (25 days to 5 months) did not show any relapse of the pericardial effusion.

Conclusion: Percutaneous balloon pericardiotomy is a safe and effective procedure to achieve a durable decompression of pericardial space in patients with malignant effusion and at high surgical risk. The simultaneous use of ultrasound and fluoroscopy facilitates the approach to the pericardic space.