Author + information
- Received April 14, 1992
- Revision received June 19, 1992
- Accepted June 23, 1992
- Published online January 1, 1993.
- Andrew A. Ziskind, MD, FACC∗,a,
- A.Craig Pearce, MDa,
- Cyndi C. Lemmon, MSNa,
- Steven Burstein, MD∗,
- Lawrence W. Gimple, MD, FACC†,
- Howard C. Herrmann, MD, FACC‡,
- Raymond McKay, MD, FACC§,
- Peter C. Block, MD, FACC∥,
- Howard Waldman, MD, FACC¶ and
- Igor F. Palacios, MD, FACC#
- ↵∗Address for correspondence: Andrew A. Ziskind, MD, Cardiac Catheterization Laboratory, University of Maryland, 22 South Greene Street, Room N3W77, Baltimore, Maryland 21201-1595.
Objectives. This study describes the technique, clinical characteristics and results of the first 50 patients undergoing percutaneous balloon pericardiotomy as part of a multicenter registry.
Background. Percutaneous balloon pericardiotomy involves the use of a percutaneous balloon dilating catheter to create a nonsurgical pericardial window.
Methods. Patients eligible for percutaneous balloon pericardiotomy had either cardiac tamponade (n = 36) or a moderate to large pericardial effusion (n = 14). In addition to clinical follow-up, serial echocardiograms and chest X-ray films were obtained.
Results. The procedure was considered successful in 46 patients after a mean follow-up period of 3.6 ± 3.3 months. Two patients required an early operation, one for bleeding from a pericardial vessel and one for persistent pericardial catheter drainage. Two patients required a late operation for recurrent tampomde. Minor complications of the procedure included fever in 6 of the first 37 patients (studied before the prophylactic use of antibiotic agents), thoracentesis or chest tube placement in 8 and a small spontaneously resolving pneumothorax in 2. Despite the short-term success of this procedure the long-term progcosis of the 44 patients with malignant pericardial disease remained poor (mean survival time 3.3 ± 3.1 months).
Conclusions. Percutaneous balloon pericardiotomy is successful in helping to manage large pericardial effusions, particularly in patients with a malignant condition. It may become the preferred treatment to avoid a more invasive procedure for patients with pericardial effusion and a limited life expectancy.
☆ This study was presented in part at the 41st Annual Scientific Session, American College of Cardiology, Dallas, Texas, April 1992. It was supported in part by a grant from Mansfield/Boston Scientific Inc., Walertown, Massachusetts.
- Received April 14, 1992.
- Revision received June 19, 1992.
- Accepted June 23, 1992.