[Percutaneous balloon pericardiotomy for the treatment of a malignant pericardial tamponade].
METHODS
A 72-year old man was admitted because of increasing dyspnoea, failing fitness and weight loss. Physical examination was unremarkable except for decreased heart sounds.


METHODS
He was anaemic (haemoglobin 11.7 g/dl), erythrocyte sedimentation rate was raised (80/90 mm) as was C-reactive protein (169 mg/dl). Chest radiogram showed tent-like widening of the cardiac silhouette and a 6 cm space-occupying lesion in the left hilus. Echocardiography revealed pericardial effusion of up to 2.3 cm (epi- to pericardium).


METHODS
Because of an increase in dyspnoea and pericardial effusion a pericardiocentesis was performed. This fluid and needle biopsy of the space-occupying lesion revealed small-cell carcinoma. 6 days after the pericardiocentesis the dyspnoea further increased as did the pericardial effusion (to 3.9 cm). Percutaneous balloon pericardiotomy was uneventfully performed. During a follow-up period of 14 months there were no further pericardial effusions.


CONCLUSIONS
Percutaneous balloon pericardiotomy can be undertaken as a minimally invasive treatment of symptomatic pericardial effusion. It should be considered as an alternative to surgical creation of a pericardial window, especially in very ill patients.
Grumbach
I M
IM
Medizinische Klinik III (Kardiologie, Angiologie, internistische Intensivmedizin, Friedrich-Schiller-Universität Jena.
Werner
G S
GS
Figulla
H R
HR
D000368:Aged; D021721:Balloon Occlusion; D001707:Biopsy, Needle; D018288:Carcinoma, Small Cell / Q000150:complications / Q000175:diagnosis; D002305:Cardiac Tamponade / Q000209:etiology / Q000628:therapy*; D002404:Catheterization; D004417:Dyspnea / Q000209:etiology; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis; D006801:Humans; D008297:Male; D019152:Paracentesis; D010490:Pericardial Effusion / Q000150:complications* / Q000209:etiology; D010492:Pericardiectomy / Q000379:methods*
Perkutane Ballonperikardiotomie zur Behandlung einer malignen Perikardtamponade.