Limitatoins of surgical methods of pericardial drainage. Echocardiographic observations.
To assess the efficacy of surgical methods of pericardial drainage in preventing the accumulation of pericardial effusion, we performed M-mode and cross-sectional echocardiograms in 26 patients before and one week after the creation of a pericardial window or leaving the pericardium open after cardiac surgery. A pericardial window was created in six patients (group 1) who had pericardial effusions. Group 2 consisted of 20 patients who had heart surgery. Echocardiography disclosed moderate or large pericardial effusions preoperatively in all group 1 patients but in one of the group 2 patients. Following operation, three of the group 1 patients had complete clearing of pericardial effusion, while three showed reaccumulation. In group 2, thirteen patients had either no effusion or a small effusion. Seven patients had moderate or large pericardial effusions that were located posterior to the heart; only one had an anterior pericardial effusion. Cross-sectional echocardiography showed posterior loculation of effusion in six of the seven patients. Pericardial drainage is not always effective in preventing accumulation of pericardial effusions.
D006348:Cardiac Surgical Procedures; D004322:Drainage; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000517:prevention & control* / Q000601:surgery; D010496:Pericardium / Q000601:surgery; D011183:Postoperative Complications; D012008:Recurrence