Cardiac tamponade in uremic pericarditis: Surgical approach and management

Abstract

More cases of uremic pericarditis are successfully treated by the clinician as a result of improved techniques of dialysis and kidney transplantation. Cardiac tamponade, a further complication of uremic pericarditis, must be treated by pericardiocentesis. If the clinical condition has not been improved after pericardiocentesis, anterior pericardiectomy may be performed with excellent results. Peritoneal dialysis or hemodialysis with regional heparinization is performed as necessary before and after surgery to control the biochemical changes of uremia. During the 3 years from 1970 to 1972, nine patients underwent anterior pericardiectomy for relief of cardiac tamponade in our institution. Seven patients made an uneventful recovery and were discharged to resume long-term intermittent dialysis; two of these patients later received kidney transplants.