Comparison of posterior pleural pericardial window and pericardiocentesis in patients with cardiac tamponade

Abstract

Objective: In our study, we aimed to compare the results of patients who underwent pericardiocentesis and posterior pleura-pericardial window in the treatment of cardiac tamponade. Materials and Methods: The results of all patients presenting to our hospitals with cardiac tamponade and who underwent pericardiocentesis and/or posterior pleural pericardial window (PPPW) between January 2010 and May 2021 were compared and analyzed in a retrospective review. They were divided into Group A comprising 37 patients who underwent pericardiocentesis, and Group B comprising 37 patients who underwent PPPW. Results: The mean age was 62.8 ± 7.6 years, with 54.1% males in Group A compared to 59.5 ± 12.3 years and 62.2% males in Group B. The most common etiology in Groups A and B was idiopathic in 24.3% and 16.2%, respectively. Atrial fibrillation occurred in 32.4% versus 10.8% in Groups A and B, respectively (P < 0.02), and recurrent cardiac tamponade in 24.3% versus 5.4% in Groups A and B, respectively (P < 0.02). The 30 days' mortality was 5.4% versus 10.8% in Groups A and B, respectively (P < 0.39). Conclusions: Pericardiocentesis is a safe and effective treatment for cardiac tamponade in select cases; however, PPPW was associated with a lower incidence of postoperative atrial fibrillation and recurrent cardiac tamponade at 6 and 12 months' follow-up, respectively. PPPW appears a more effective treatment option, especially in recurrent pericardial effusion.