title: Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions.
abstract: OBJECTIVE
  To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period.
  
  
  METHODS
  From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type.
  
  
  RESULTS
  The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45%) patients, neoplastic in 4 (20%), resulting from hypothyroidism in 3 (15%), tuberculous in 2 (10%), due to cholesterol in 1 (5%), and chylopericardial in 1 (5%). The biopsy was positive in 30% of the patients, and the etiology could not be defined in 45% of the patients.
  
  
  CONCLUSIONS
  Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. PauloPego@incor.usp.br
authors.forename: P M
authors.initials: PM
authors.lastname: Pêgo-Fernandes
authors.forename: F
authors.initials: F
authors.lastname: Fernandes
authors.forename: B M
authors.initials: BM
authors.lastname: Ianni
authors.forename: S S
authors.initials: SS
authors.lastname: Rohr
authors.forename: I M
authors.initials: IM
authors.lastname: Bernardelli
authors.forename: F B
authors.initials: FB
authors.lastname: Jatene
authors.forename: S A
authors.initials: SA
authors.lastname: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D010496:Pericardium / Q000601:surgery*; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*