PERCUTANEOUS BALLOON PERICARDIOTOMY FOR MALIGNANT PERICARDIAL TAMPONADE

Recurrent pericardial effusion or tamponade can complicate malignant d isease. The medical approach with pharmacologic agents has a high recu rrence rate, Balloon pericardiotomy (BP) may provide a less invasive a lternative to surgery, We pet-formed BP in ten high-risk patients with malignant pericardial tamponade (MPT), BP was performed,vith aseptic technique under fluoroscopic and echocardiographic guidance, We used a percutaneous subxiphoid approach. A 20- to 25-mm-wide and 4-cm-long b alloon was introduced over a stiff guide wire, positioned across the p arietal pericardium, and manually inflated until the waisting disappea red, Echocardiographic study and chest radiograph were taken before, i mmediately after the procedure, and during follow-up. The procedure wa s successful and well tolerated in all patients. There were no immedia te or late complications. No patients developed recurrence of pericard ial effusion at up to 10 months' follow-up. In conclusion, BP can be p erformed in patients with MPT with high rate of procedural success. It may become the preferred treatment to avoid a more invasive procedure in these critically ill patients.