- 作者：Juan Ruiz-Garcí ; a ; j.ruizgarcia@hotmail.com ; Santiago Jimé ; nez-Valero ; Raú ; l Moreno ; Guillermo Galeote ; Á ; ngel Sá ; nchez-Recalde ; Luis Calvo ; Mar Moreno-Yangü ; ela ; Sebastiá ; n Carrizo ; Sergio Garcí ; a-Blas ; José ; Luis Ló ; pez-Sendó ; n
- 关键词：MPE ; malignant pericardial effusion ; PBP ; percutaneous balloon pericardiotomy
- 刊名：Revista Española de Cardiología (English Edition)
- 出版年：2013
- 出版时间：May, 2013
- 年：2013
- 卷：66
- 期：5
- 页码：357-363
- 全文大小：1642 K
Introduction and objectives
Malignant pericardial effusion has a high recurrence rate after pericardiocentesis. We sought to confirm the efficacy of percutaneous balloon pericardiotomy as the initial treatment of choice for these effusions.Methods
Retrospective analysis of the clinical, echocardiographic, and follow-up characteristics of a consecutive series of percutaneous balloon pericardiotomies carried out in a single center in patients with advanced cancer.
Results
Seventeen percutaneous balloon pericardiotomies were performed in 16 patients with a mean age of 66.2 (15.2) years. Fourteen?patients had pathologically confirmed metastatic neoplastic disease, 3?had previously required pericardiocentesis, and in the remaining patients percutaneous balloon pericardiotomy was the first treatment for the effusion. All patients had a severe circumferential effusion, and most presented evidence of hemodynamic compromise on echocardiography. In all cases, the procedure was successful, there were no acute complications, and it was well tolerated at the first attempt. There were no infectious complications during follow-up (median, 44 [interquartile range, 36-225] days). One patient developed a large pleural effusion that did not require treatment. Three patients needed a new pericardial procedure: 2 had elective pericardial window surgeries and 1 had a second percutaneous balloon pericardiotomy.
Conclusions
Percutaneous balloon pericardiotomy is a simple, safe technique that can be effective in the prevention of recurrence in many patients with severe malignant pericardial effusion. The characteristics of this procedure make it particularly useful in this group of patients to avoid more aggressive, poorly tolerated approaches.