Percutaneous balloon pericardial window for patients with symptomatic pericardial effusion.
OBJECTIVE
To describe the technique and our experience in percutaneous creation of a pericardial window in patients with recurrent pericardial effusion.


METHODS
Eleven consecutive patients (9 men, 2 women; mean age 61 years, range 37-79 years) with recurrent pericardial effusion were treated from December 1994 to October 2000. Malignant effusion was the cause of cardiac tamponade in nine patients. Puncture of the pericardial space was performed under ultrasound and fluoroscopic guidance. Once a guidewire was safely positioned in the pericardial cavity and the wall of the pericardium was identified, the pericardial keyhole was dilated with an 18 mm balloon catheter. A temporary (1-3 day) 8 Fr pigtail catheter was inserted in order to stabilize the tract and aspirate the fluid.


RESULTS
The aim of creating a pericardial window was achieved in all 11 patients. There were three recurrences (27%) of pericardial effusion and three early deaths (27%) due to progression of the underlying disease, which occurred within 30 days following the procedure. Follow-up ranged from 6 days to 382 days, mean 147 days.


CONCLUSIONS
Percutaneous creation of a pericardial window can be a safe therapeutic alternative for patients with symptomatic pericardial effusion, particularly if this has a malignant etiology.
Facultad de Medicina, Clinica Universitaria, Universidad de Navarra, Pio XII 36, 31008 Pamplona, Navarra, Spain.
Loreto Garcia
LG
del Barrio
José Hernando
JH
Morales
Carlos
C
Delgado
Alberto
A
Benito
Javier
J
Larrache
Antonio
A
Martinez-Cuesta
José Ignacio
JI
Bilbao
D000328:Adult; D000368:Aged; D021721:Balloon Occlusion; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000628:therapy*; D010491:Pericardial Window Techniques; D015641:Radiography, Interventional / Q000379:methods*; D016896:Treatment Outcome