Drainage of Pericardial Effusions: Percutaneous or Surgical?

Abstract

LEUNG, ET AL : Drainage of Pericardial Effusions: Percutaneous or Surgical? Background: There are 2 modes of drainage of pericardial effusions: percutaneous pericardiocentesis (PP) and surgical pericardiotomy (SP). Certain features, which are indicative of cardiac tamponade, should guide us to the choice of drainage of pericardial effusions. It is unclear if this is followed in clinical practice. Objective: To review patients with pericardial drainage done for a period of 36 months, and to correlate the features with the choice of drainage mode. Results: 39 patients and 47 procedures (20 PP and 27 SP) were reviewed. Several clinical features were correlated with the use of PP: dyspnoea on exertion, dyspnoea at rest, orthopnoea, tachycardia, elevated jugular venous pressure and hypotension. Pulsus paradoxus was not adequately checked. Electrocardiographic and radiographic findings were similar between the 2 modes. 91% of the patients had large effusions by echocardiography. Right atrial collapse and right ventricular collapse occurred more frequently in the group of PP. Conclusion: Some features were more relied by us to indicate the presence of cardiac tamponade. Their presence should lead us more to the use of percutaneous drainage and they should be checked thoroughly. The decision to drain and the selection should be assessed after an integration of all these features. (J HK Coll Cardiol 1999;7:104-108)