Surgical pericardial drainage in a series of 235 consecutive patients: an 8-year experience

Purpose Pericardial effusion has various underlying etiologies, and clinicians should identify those that require targeted therapy. Pericardial effusion can be drained either with needle aspiration or surgical procedures. In the following article, we opted to report the results of our 8-year experience of surgical pericardial drainage on 235 consecutive patients. Methods We retrospectively analyzed the medical records of 235 consecutive patients with pericardial effusion and/or tamponade who were submitted to surgical drainage (subxiphoid or left anterolateral pericardiostomy) between the years 2005 and 2013. We aimed to assess the etiology of pericardial effusion, total intra-and post-procedure drainage, length of in-hospital stay, effectiveness of surgical procedures, and related in-hospital mortality. Results We identified 235 patients, 161 (68.51 %) with severe, 63 (26.80 %) with moderate, and 11 (4.68 %) with mild pericardial effusion. Cardiac tamponade was diagnosed in 91 (38.72 %). The most common established etiologies were idiopathic, uremic, and malignant effusion, respectively. Higher total drained volume was more common in pericardial effusions of malignant etiology than idiopathic (mean difference = 272.02, p = 0.005) or iatrogenic (mean difference = 1096.80, p = 0.001). Mean length of post-procedure drainage was 4.6 days. Intra-operative mortality was 0 % and post-operative was 0.8 % (n = 2). Conclusion Assessing the data, we concluded that surgical pericardial drainage is a safe and effective method for management of adults with pericardial effusion.