Pericardial tamponade and large pericardial effusions: causal factors and efficacy of percutaneous catheter drainage in 50 patients

In 50 patients treated from January 1998 through March 2002 for pericardial effusion and tamponade, we retrospectively investigated the efficacy of percutaneous placement of an indwelling pericardial catheter guided by 2-dimensional echocardiography and fluoroscopy. We also investigated causation. I...

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Bibliographic Details
Published in:Texas Heart Institute journal 2004, Vol.31 (4), p.398-403
Main Authors: Kabukcu, Mehmet, Demircioglu, Fatih, Yanik, Ekrem, Basarici, Ibrahim, Ersel, Filiz
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Cardiac Catheterization
Cardiac Tamponade - etiology
Cardiac Tamponade - pathology
Cardiac Tamponade - surgery
Catheters, Indwelling
Child
Clinical Investigation
Decompression, Surgical
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pericardial Effusion - etiology
Pericardial Effusion - pathology
Pericardial Effusion - surgery
Pericardiocentesis
Pericardium - pathology
Retrospective Studies
Suction
Treatment Outcome
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Summary:In 50 patients treated from January 1998 through March 2002 for pericardial effusion and tamponade, we retrospectively investigated the efficacy of percutaneous placement of an indwelling pericardial catheter guided by 2-dimensional echocardiography and fluoroscopy. We also investigated causation. In 80% of the patients, we were able to determine specific causes through clinical, serologic, and cytologic investigation: cancer in 15 patients, chronic renal failure in 11, systemic lupus erythematosus in 2 rheumatoid arthritis in 2, Dressler syndrome in 2, tuberculosis in 1, blunt chest trauma in 1, purulent pericarditis in 1, and probably viral pericarditis in 5. No specific cause could be determined in 10 patients (20%). We did not observe any complication due to the procedure. Two patients died during hospitalization. After hospitalization, 9 patients with metastatic cancer died within 3 months. A 2nd percutaneous drainage procedure was required in 2 cancer patients. Recurrence of pericardial effusion and tamponade and the requirement of pericardiectomy occurred in 2 patients with perfusion of unknown cause and in 1 patient with perfusion due to rheumatoid arthritis. Histologic examination of pericardial tissue in patients with idiopathic disease showed fibrinous pericarditis but no causal factor. In the group with idiopathic pericardial effusion, 2 patients with multiple mediastinal lymphadenopathy underwent mediastinal exploration; biopsy revealed nonspecific lymphadenitis and fibrinous pericarditis. In patients with large pericardial effusions and tamponade, the specific cause was in most cases already known or obtained by initial clinical and laboratory investigation. Sufficient cardiac decompression was achieved by percutaneous pigtail catheter drainage.
ISSN:0730-2347