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European Heart Journal 1995 16(2):184-187;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Percutaneous balloon pericardiostomy for treatment of cardiac tamponade

E. DI SEGNI, J. LAVEE*, E. KAPLINSKY and Z. VERED

The Heart Institute and Sheba Medical Center, and Sackler School of Medicine Tel-Aviv University, Israel
*Thoracic Surgery Department, Sheba Medical Center, and Sackler School of Medicine Tel-Aviv University, Israel

Received 17 February 1994; revised 25 May 1994; .

Correspondence: Elio DI Segni, MD, Heart Institute, Sheba Medical Center, Tel-Hashomer 52621, Israel.

Abstract

Percutaneous balloon pericardiostomy was performed in eight severely ill patients with malignancy (seven patients) and chronic renal failure (one patient). To investigate the feasibility of balloon pericardiostomy as a bedside procedure, echocardiography was used in addition to fluoroscopy in monitoring the procedure. The pericardium was entered from the standard subxiphoid site. An 18 to 25 mm, 3 or 4 cm long, balloon catheter, introduced over a stiff guidewire was inflated across the parietal pericardium. Creation of a pericardial opening was obtained in each of the eight patients. Bleeding from the needle entry site was the only complication observed in one patient. The balloon catheter could be localized by echocardiography only in 218 cases. Two patients died, 3 and 14 days after the procedure, from the primary disease; six patients were still alive at follow-up ranging from 32 to 342 days. No recurrence of cardiac tamponade was observed in any patient.

Percutaneous balloon pericardiostomy is efficacious and safe in relieving pericardial tamponade and preventing its recurrence in severely ill patients. Fluoroscopy is needed to monitor the procedure. The value of echocardiography is limited for follow-up controls of pericardial effusion.

Key Words: Pericardial effusion • cardiac tamponade • balloon pericardiostomy • malignancy


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