Video-thoracoscopic pericardial drainage in the treatment of pericardial effusions.
OBJECTIVE
To assess efficacy and safety of videothoracoscopic pericardial drainage in the treatment and diagnostic of pericardial effusion through 26 cases review.


METHODS
From April 2005 to December 2007, 26 patients with pericardial effusion underwent a video-thoracoscopic pericardial window. Median age was 48.2 years old. Dyspnea was the most frequent symptom followed by thoracic pain. The procedure was performed in lateral decubitus, under general anesthesia and selective intubation with the aid of three trocars.


RESULTS
Procedure accomplish was feasible in 25 cases. One conversion occurred. In 61.53% of the cases the procedure was able to modify the initial diagnosis. Microbiology and tissue culture were negative in all cases. Neoplasia was present in nine cases, tuberculosis in two, aspergillosis in one, postoperative heart surgeries in three; lupus in two, uremia in one and idiopathy in eight. Associated pleuropulmonary procedures were performed in four cases. No deaths related to the procedure occurred. One late recurrence was recorded.


CONCLUSIONS
The procedure is feasible, safe, reproducible and allowed an etiologic diagnostic. Specific treatment could be initiated in some cases. The intervention could possibly be the new gold standard treatment of pericardial effusion in selected patients.
Palma
José Honório
JH
Federal University of São Paulo, São Paulo Medical School, São Paulo.
Gaia
Diego Felipe
DF
Guilhen
José Cícero Stocco
JC
Branco
João Nelson Rodrigues
JN
Buffolo
Enio
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods* / Q000592:standards; D055815:Young Adult