Percutaneous balloon pericardiotomy for patients with malignant pericardial effusion including three malignant pleural mesotheliomas

Ten patients were enrolled in this study to evaluate the therapeutic value of percutaneous balloon pericardiotomy in patients with symptomatic pericar dial effusion secondary to malignant diseases. Four patients had breast can cer; 2 had lung cancer; 1 had non-Hodgkin's lymphoma; and 3 had malignant p leural mesothelioma, which is commonly seen in Central Anatolian region of Turkey. All patients underwent percutaneous balloon pericardiotomy with mon ofoil balloons (Mansfield, NuMed). No complication was seen during these pr ocedures. In 3 patients, the balloon could not be expanded completely and w as entered from a more lateral position by a second puncture. There was no recurrence of pericardial effusion in 6 of 7 patients without mesothelioma. After percutaneous balloon pericardiotomy, surgical subxiphoid windowing w as performed due to drainage greater than 100 mL/day in a patient with lung cancer and in 1 patient with mesothelioma. In the other 2 patients with me sothelioma, recurrence of pericardial effusion was seen and then subxiphoid surgical windowing was performed due to development of cardiac tamponade i n 1 of them. All the patients died 68.6 +/- 36 days later due to the primar y malignancies. The survival time of patients with mesothelioma was shorter than that of the others (p < 0.05). These results suggest that percutaneous balloon pericardiotomy may be used in the treatment of patients with malignant pericardial effusion as an alte rnative to surgical pericardial window creation. But in patients with malig nant pleural mesothelioma, the success rate of this procedure was lower tha n that of the others.