Cardiac Tamponade Surgery, Which Method To Choose

Abstract

Objective: Cardiac tamponade (CT) represents a life-threatening condition and different methods are applied in the surgical treatment. We have reviewed the results of 100 patients who had subxiphoid pericardial drainage, pericardio-peritoneal window and thoracotomy after the diagnosis of CT. Material and Methods: The study group consisted of 100 patients diagnosed with CT from January 2005 to January 2011 at our institution. Subxiphoid pericardial drainage was performed in 35 (35%) patients (group A). Pericardio-peritoneal window performed in 20 (20%) patients (group B). Thoracotomy was performed in 45 (45%) patients (group C). Data on medical history, characteristics of the pericardial fluid, treatment strategy and follow-up data were collected. Results: Malignant diseases, tuberculosis and idiopathic were primary cause of tamponade (57%, 17% and 15% respectively). Major and minor complications were as fallows; group A: 5%, 5%; group B: 5%, 10%; group C: 4%, 13% respectively. Recurrance ≤ 90 day were as fallows; group A: 20%; group B: 15%; group C: 6%. Thirty day morbidity; group A: 11%, group B: 15%, group C: 20%. Mortality; grup A: 20%, group B: 25%, group C: 22%. Conclusion: Major complication rates of these methods are close to each other, but more invasive method of thoracotomy, which has the lowest recurrence rates and requires the operating room environment. Implementation in intensive care unit and under local anesthesia and are the most importanat advantages of subxiphoid pericardial drainage and pericardio-peritoneal window methods. Copyright © 2011 by Türkiye Klinikleri.