THORACOSCOPIC PERICARDIAL FENESTRATION, A 1ST EXPERIENCE OF A NEW APPROACH

Surgical treatment of pericardial effusions are, in general, treated b y methods using a subxiphoid or a transthoracic route. The former is c riticized for the high recurrence rate, the latter for the high incide nce of respiratory complications. To minimize these problems and in vi ew of the growing enthusiasm for using minimal invasive techniques, we treated one patient with pericardial effusion by using video-assisted thoracoscopy for the creation of a pericardial window. We achieved an adequate drainage, and the postoperative pain and pulmonary dysfuncti on were minimal. The operative technique and pitfalls are discussed in this report. Thoracoscopic pericardial fenestration might facilitate a much less aggressive transthoracic approach to the pericardium which is of great importance, as many of these patients are already in a po or clinical condition.