THORACOSCOPIC PERICARDIAL FENESTRATION - DIAGNOSTIC AND THERAPEUTIC ASPECTS

The cause of cardiac tamponade is only established in 50% of cases. Th is problem is most commonly treated by pericardiocentesis alone, peric ardiotomy being reserved for cases of recurrence and pericardiectomy f or those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscop e is presented. Pericardial and pleural biopsies were performed, toget her with cytological and biochemical analysis of the pericardial and p leural fluid where present. This procedure established the aetiology o f effusion in all cases. In malignant pericardial effusion bleomycin w as used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%) .