Percutaneous versus surgical drainage of non-iatrogenic pericardial effusion

Abstract

Pericardial effusion can be a life-threatening condition when fluid accumulation is fast and large. Emergency drainage is then life saving but no consensus exists as to the preferential use of a percutaneous or surgical approach. To compare complications during follow-up and length of stay, one and six-months mortality and recurrences. All patients admitted for symptomatic pericardial effusion in 2017 in our tertiary Intensive Cardiac Care Center were prospectively included. Patients were analyzed depending on the type of drainage used: surgical of percutanous. A total of 129 patients were admitted for pericardial effusion and 92 were drained: 54 (58.7%) by a surgical and 38 (41.3%) by a percutanous way. At 6-months, no mortality or recurrences between groups were observed (12 (22.2%) versus 14 (36.9%) deaths; P = 0.12 and 6 (11.1%) versus 9 recurrences (23.7%); P = 0.11, respectively in the surgical and percutanous group). No in-hospital complications were found (4 (7.4%) for the surgical group, 1 (5.3%) for percutanous group; P = 0.39). length of in-hospital stay was shorter for patients treated by percutaneous drainage (5.9 days (±4.4) versus 8.2 days (±4.9); P = 0.02). Percutaneous drainage appears to be a reliable approach to treat symptomatic percicardial effusions without differences in terms of complications, recurrences or mortality compared to surgical drainage. Length of stay is shorter that may justify to use it at first line therapy.