PERCUTANEOUS BALLOON PERICARDIOSTOMY FOR TREATMENT OF CARDIAC-TAMPONADE

Percutaneous balloon pericardiostomy was performed in eight severely i ll patients with malignancy (seven patients) and chronic renal failure (one patient). To investigate the feasibility of balloon pericardiost omy as a bedside procedure, echocardiography was used in addition to f luoroscopy in monitoring the procedure. The pericardium was entered fr om the standard subxiphoid site. An 18 to 25 mm, 3 or 4 cm long, ballo on 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 c ould be localized by echocardiography only in 2/8 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. N o recurrence of cardiac tamponade was observed in any patient. Percuta neous balloon pericardiostomy is efficacious and safe in relieving per icardial tamponade and preventing its recurrence in severely ill patie nts. Fluoroscopy is needed to monitor the procedure. The value of echo cardiography is limited for follow-up controls of pericardial effusion .