Pericardioperitoneal and pericardiopleural windows: A drainage technique for the treatment of recurrent cardiac tamponade. A case report.

Abstract

IntroductionGiven that pericardial effusion may sometimes lead to cardiac tamponade and chronic heart failure, its management seems absolutely essential. In case of a poor response to medical therapy, surgical drainage of the effusion is required. Although some drainage procedures for pericardial effusion (e.g., temporary puncture, pericardiopleural drainage, and pericardioperitoneal drainage) are currently used in clinical practice, their long-term efficacy remains unclear.Presentation of caseWe present a case of a 58-year old female with recurrent pericardial effusion secondary to systemic lupus erythematosus. Since she was relatively young and on steroids, long-term patency of pericardial fenestration needed to be insured without any device. Hence, we created 2 pericardial windows, pericardioperitoneal and pericardiopleural, via a single-incision subxiphoid approach to allow the effusion to drain into the abdominal and thoracic cavities.DiscussionIt is important to efficiently manage pericardial effusion because it can lead to more serious conditions such as cardiac tamponade and chronic heart failure. Our technique, which involves making a small incision, can reduce the risk of recurrence.ConclusionSimultaneous creation of pericardioperitoneal and pericardiopleural windows is simple and can be feasibly performed to prevent the recurrence of pericardial effusion.