title: Video-assisted pericardial fenestration for effusions after cardiac surgery.
abstract: Delayed-onset pericardial effusion following cardiac surgery can give rise to significant morbidity due to its presentation as well as management by traditional surgical techniques. An institutional experience of a video-assisted thoracoscopic technique to create a pericardial window, with the advantages of a minimally invasive approach combined with excellent visualization in such patients, was reviewed. A retrospective analysis was conducted on all patients undergoing video-assisted thoracoscopic for delayed pericardial effusion after cardiac surgery from January 2001 to January 2006 at our center. Seven patients with echocardiographically diagnosed delayed tamponade underwent video-assisted thoracoscopy; 5 were receiving anticoagulants after valve replacement, and 2 had undergone heart transplantation. Pericardial windows were created under general anesthesia and single-lung ventilation using 2 to 3 trocars. Mean operative time was 45 min. There were no complications of the thoracoscopic technique. Video-assisted thoracoscopic creation of a pericardial window is safe and effective treatment for loculated pericardial effusions secondary to cardiac surgery.
authors.affiliation: Department of Cardiothoracic Surgery, American Heart Institute, PO Box 25610, 1311 Nicosia, Cyprus. georgios_georghiou@cytanet.com.cy
authors.forename: Georgios P
authors.initials: GP
authors.lastname: Georghiou
authors.forename: Eyal
authors.initials: E
authors.lastname: Porat
authors.forename: Avi
authors.initials: A
authors.lastname: Fuks
authors.forename: Bernardo A
authors.initials: BA
authors.lastname: Vidne
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
mesh_terms: D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery; D004452:Echocardiography; D016027:Heart Transplantation / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020519:Pericardiocentesis / Q000379:methods*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome