title: Pericardiocentesis with extended catheter drainage: an effective therapy.
abstract: BACKGROUND
  The most effective method for managing pericardial effusions has yet to be identified. This study evaluates the efficacy and safety of echocardiographic-guided placement of indwelling catheters into the pericardial space.
  
  
  METHODS
  This study consists of a 5-year retrospective chart review of consecutive patients coded with benign or malignant pericardial effusions who presented for drainage procedures to a single surgeon at a 260-bed hospital. Complication, recurrence, and survival rates were studied.
  
  
  RESULTS
  Between January 1996 and August 2001, a total of 29 pericardial drainage procedures were performed; eight of those also underwent talc sclerosis. Mean follow-up was 16 months. Three patients (10%) required conversion to thoracotomy; of those remaining, 25 of the 26 procedures were performed under local anesthesia with intravenous sedation. The identified etiologies for pericardial effusions were malignancy (76%), idiopathic (14%), postcoronary artery bypass grafting procedure (3%), viral pericarditis (3%), and uremia (3%). Echocardiographic features of tamponade were documented in 72%. Mean +/- SEM length of postprocedure in-hospital stay was 6.7 +/- 0.82 days. The overall complication rate was 10% (pneumothorax and cardiac injury). Recurrence rate within 30 days was 7%. Thirty-day mortality was 21%, and more than 90-day survival was 72%.
  
  
  CONCLUSIONS
  Pericardiocentesis with extended catheter drainage is a safe treatment for management of clinically significant, malignant and benign, pericardial effusions and can be performed effectively under local anesthesia with intravenous sedation.
authors.affiliation: Department of Surgery, St. Joseph Mercy Hospital, Ann Arbor, Michigan 48106, USA.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Buchanan
authors.forename: Vita V
authors.initials: VV
authors.lastname: Sullivan
authors.forename: Richard
authors.initials: R
authors.lastname: Lampman
authors.forename: Mohan G
authors.initials: MG
authors.lastname: Kulkarni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020519:Pericardiocentesis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies