A patient suffered from recurrent pericardial effusions following hear
t transplantation. Repeated pericardiocentesis and insertion of perica
rdial drains could not resolve the problem and therefore surgical inte
rvention was necessary, The procedure was performed as a minimally inv
asive thoracoscopic pericardial fenestration. Four months postoperativ
e the patient was without recurrences, This method of pericardial fene
stration after heart transplantation has been used for the first time.