Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: Description of technique and report of the first 50 cases

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Abstract

Objectives. This study describes the technique, clinical characteristics and results of the first 50 patients undergoing percutaneous balloon pericardiotomy as part of a multicenter registry. Background. Percutaneous balloon pericardiotomy involves the use of a percutaneous balloon dilating catheter to create a nonsurgical pericardial window. Methods. Patients eligible for percutaneous balloon pericardiotomy had either cardiac tamponade (n = 36) or a moderate to large pericardial effusion (n = 14). In addition to clinical follow-up, serial echocardiograms and chest X-ray films were obtained. Results. The procedure was considered successful in 46 patients after a mean follow-up period of 3.6 ± 3.3 months. Two patients required an early operation, one for bleeding from a pericardial vessel and one for persistent pericardial catheter drainage. Two patients required a late operation for recurrent tampomde. Minor complications of the procedure included fever in 6 of the first 37 patients (studied before the prophylactic use of antibiotic agents), thoracentesis or chest tube placement in 8 and a small spontaneously resolving pneumothorax in 2. Despite the short-term success of this procedure the long-term progcosis of the 44 patients with malignant pericardial disease remained poor (mean survival time 3.3 ± 3.1 months). Conclusions. Percutaneous balloon pericardiotomy is successful in helping to manage large pericardial effusions, particularly in patients with a malignant condition. It may become the preferred treatment to avoid a more invasive procedure for patients with pericardial effusion and a limited life expectancy. © 1993.

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Ziskind, A. A., Pearce, A. C., Lemmon, C. C., Burstein, S., Gimple, L. W., Herrmann, H. C., … Palacios, I. F. (1993). Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: Description of technique and report of the first 50 cases. Journal of the American College of Cardiology, 21(1), 1–5. https://doi.org/10.1016/0735-1097(93)90710-I

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