title: Comparison of surgical pericardial drainage with percutaneous catheter drainage for pericardial effusion.
abstract: OBJECTIVE
  We sought to investigate the outcomes for different treatments of pericardial effusions.
  
  
  BACKGROUND
  The optimal initial management for symptomatic pericardial effusions remains controversial.
  
  
  METHODS
  We performed a 3-year retrospective, single-institution study comparing open surgical drainage to percutaneous pericardiocentesis for symptomatic pericardial effusions.
  
  
  RESULTS
  Between 2007 and 2009, a total of 193 patients underwent an initial drainage procedure for a pericardial effusion (n = 121 [62.7%] pericardiocentesis; n = 72 [37.3%] open surgical drainage). Compared to those treated with pericardiocentesis, treatment with open surgical drainage was associated with a higher complication rate (4.9% vs 26.4%; P<.0001; odds ratio [OR], 6.9; 95% confidence interval [CI], 2.6-18.2). Treatment with pericardiocentesis was associated with a higher rate of repeat procedures to drain a recurrent effusion compared to open surgical drainage (28.9% vs 2.8%; P<.0001; OR, 14.2; 95% CI, 3.3-61.3). Thirty-day mortality (19.8% surgical group vs 18.1% pericardiocentesis group; P=.8) and long-term survival (P=.4) did not differ between the groups.
  
  
  CONCLUSIONS
  There is no significant difference in overall mortality between open surgical drainage and percutaneous pericardiocentesis for symptomatic pericardial effusions. There may be more procedural complications following surgical drainage of a pericardial effusion, and a greater need for repeat procedures if the effusion is drained using pericardiocentesis.
authors.affiliation: Massachusetts General Hospital, Division of Cardiology, 55 Fruit Street, Boston, MA 02114 USA. ajsaltzman@partners.org
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Saltzman
authors.forename: Yehuda E
authors.initials: YE
authors.lastname: Paz
authors.forename: A Garvey
authors.initials: AG
authors.lastname: Rene
authors.forename: Philip
authors.initials: P
authors.lastname: Green
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hassanin
authors.forename: Michael G
authors.initials: MG
authors.lastname: Argenziano
authors.forename: Leroy
authors.initials: L
authors.lastname: Rabbani
authors.forename: George
authors.initials: G
authors.lastname: Dangas
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000401:mortality / Q000628:therapy*; D020519:Pericardiocentesis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome