Percutaneous pericardial catheter drainage in childhood.
The clinical course of 41 consecutive pediatric patients (mean age 7.6 +/- 5.8 years, weight 27 +/- 22 kg) who underwent percutaneous pericardial drain placement during a 3-year period were reviewed. The most common diagnoses were malignancy (20%), postpericardiotomy syndrome (17%), aseptic pericarditis (12%), and patients recovering from a Fontan type of operation (12%). Indications for drainage included increasing effusion size determined by 2-dimensional echocardiogram (48%), clinical deterioration (33%) and echocardiographic evidence of hemodynamic compromise (12%). Only 3 (7%) patients had clinical evidence of cardiac tamponade. Drainage catheter placement was accomplished percutaneously from the subxiphoid approach. Insertion was successful in all but 1 patient (98%) and successful evacuation of the pericardial space was achieved in 93% of patients. There was 1 death in a critically ill 2-week-old infant and 4 complications, 3 of which occurred in patients aged less than 2 years. Drainage catheters remained in position from 1 to 18 days (mean 3 +/- 3 days) with no late complications. There were 3 instances (7%) of drainage catheter occlusion. These data support the notion that placement of a percutaneous pericardial catheter is safe and effective in providing definitive drainage of the pericardial space in the pediatric age group. Children younger than age 2 years may be at increased risk for complications.
Zahn
E M
EM
Department of Pediatrics, Hospital For Sick Children, Toronto, Ontario, Canada.
Houde
C
C
Benson
L
L
Freedom
R M
RM
D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000453:epidemiology / Q000628:therapy*; D010491:Pericardial Window Techniques / Q000009:adverse effects / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome