The Efficiency of Surgical Subxiphoid Pericardial Drainage and Percutaneous Pericardial Drainage in Pericardial Effusions Associated with Cardiac Tamponade
C.P. Petcu, I. DrocOriginal article, no. 2, 2013
Objectives: The optimal management for pericardial effusions
with cardiac tamponade remains controversial. This study
compares the results after two commonly performed
techniques: subxiphoid surgical pericardial drainage (DPSS)
and percutaneous catheter drainage (DPPK).
Material and methods: We conducted a 5-year retrospective
study to analyse the outcome after DPSS and DPPK in
patients with non-traumatic pericardial effusions with cardiac
tamponade.
Outcomes: Patients with non-traumatic cardiac tamponade
were treated with DPSS (N=138) and DPPK (N=54). There
were no statistical differences between groups regarding: age,
drainage volume and duration of drainage. The etiology was
malignant in 72 patients and benign in 120 patients. The
2-year survival was statistically non-significant: 55,1% in the
surgical group and 44,4% in the percutaneous group, but there
was a slight prevalence of malignant diagnosis in the first group
(38% versus 35%). The 1-year survival in patients with proved
cyto-/hystological malignancy was statistically poorer than in patients with malignant diagnosis and with both negative
cytology and hystology (7% versus 33%). The 1-year freedom
of re-intervention for recurrence of pericardial effusion was
statistically better in the surgical group as in the percutaneous
one (92.8% versus 79,6%).
Conclusions: DPSS and DPPK can be both safely performed.
DPSS appears to decrease intervention-necessitating recurrence,
but it brings a minimal advantage for the malignant diagnosis
over cytology alone.
