Surgical treatment of large pericardial effusions. Etiology and long-term survival.
From 1977 to 1988 60 patients were treated for large pericardial effusion. The operation consisted of a small left anterior thoracotomy with formation of a pericardial window. In 28 patients (47%) the etiology was a malignant disease. Eight patients (29%) had malignant cells in the pericardial fluid and 23 patients (82%) had metastases to the pericardium. Seven patients (12%) had purulent pericarditis; in 4 cases Staphylococcus was found. Of the remaining 25 patients, the etiology remained unknown in 13. The 5-year survival rate was 60% among patients with nonmalignant effusions. In patients with malignant effusions only 20% were alive after 2 years. There were no deaths related to the operation. We conclude that large pericardial effusions of unknown etiology can be safely treated with a small left anterior thoracotomy. This access gives optimal possibilities for rapid diagnosis and treatment.
Olsen
P S
PS
Department of Cardiothoracic Surgery R, Gentofte County Hospital, Hellerup, Denmark.
Sørensen
C
C
Andersen
H O
HO
D001424:Bacterial Infections / Q000150:complications; D001943:Breast Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D015993:Life Tables; D008175:Lung Neoplasms / Q000150:complications; D008223:Lymphoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D010491:Pericardial Window Techniques; D015996:Survival Rate