title: Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases.
abstract: OBJECTIVE
  This study describes the technique, clinical characteristics and results of the first 50 patients undergoing percutaneous balloon pericardiotomy as part of a multicenter registry.
  
  
  BACKGROUND
  Percutaneous balloon pericardiotomy involves the use of a percutaneous balloon dilating catheter to create a nonsurgical pericardial window.
  
  
  METHODS
  Patients eligible for percutaneous balloon pericardiotomy had either cardiac tamponade (n = 36) or a moderate to large pericardial effusion (n = 14). In addition to clinical follow-up, serial echocardiograms and chest X-ray films were obtained.
  
  
  RESULTS
  The procedure was considered successful in 46 patients after a mean follow-up period of 3.6 +/- 3.3 months. Two patients required an early operation, one for bleeding from a pericardial vessel and one for persistent pericardial catheter drainage. Two patients required a late operation for recurrent tamponade. Minor complications of the procedure included fever in 6 of the first 37 patients (studied before the prophylactic use of antibiotic agents), thoracentesis or chest tube placement in 8 and a small spontaneously resolving pneumothorax in 2. Despite the short-term success of this procedure, the long-term prognosis of the 44 patients with malignant pericardial disease remained poor (mean survival time 3.3 +/- 3.1 months).
  
  
  CONCLUSIONS
  Percutaneous balloon pericardiotomy is successful in helping to manage large pericardial effusions, particularly in patients with a malignant condition. It may become the preferred treatment to avoid a more invasive procedure for patients with pericardial effusion and a limited life expectancy.
authors.affiliation: Cardiac Catheterization Laboratory, University of Maryland, Baltimore 21201-1595.
authors.forename: A A
authors.initials: AA
authors.lastname: Ziskind
authors.forename: A C
authors.initials: AC
authors.lastname: Pearce
authors.forename: C C
authors.initials: CC
authors.lastname: Lemmon
authors.forename: S
authors.initials: S
authors.lastname: Burstein
authors.forename: L W
authors.initials: LW
authors.lastname: Gimple
authors.forename: H C
authors.initials: HC
authors.lastname: Herrmann
authors.forename: R
authors.initials: R
authors.lastname: McKay
authors.forename: P C
authors.initials: PC
authors.lastname: Block
authors.forename: H
authors.initials: H
authors.lastname: Waldman
authors.forename: I F
authors.initials: IF
authors.lastname: Palacios
mesh_terms: D000368:Aged; D000772:Anesthesia, Local; D021721:Balloon Occlusion; D002305:Cardiac Tamponade / Q000453:epidemiology / Q000601:surgery*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000453:epidemiology / Q000601:surgery*; D010492:Pericardiectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D011379:Prognosis; D015641:Radiography, Interventional; D016896:Treatment Outcome