A Simple Modified Technique of Pleuropericardial Window: Towards 0% Recurrence

ABSTRACT Recurrent pericardial effusion is commonly encountered in neoplastic and infective disorders. Intervention is compulsory in patients with unstable hemodynamics and tamponading effusion. Surgical options include: pericardiocentesis, subxiphoid pericardiostomy, and pericardial window. The latter has proved to have lower incidence of recurrence; however, the technique has been continuously refined to improve the recurrence-free survival and decrease postoperative morbidity. We herein present a novel simple modification to minimize recurrence by anchoring the free edges of pericardial fenestration overlying the superior vena cava and right atrium to the chest wall. Follow-up showed no recurrence compared to 3.5% in the conventional procedure.

【摘要】复发性心包积液（Recurrent pericardial effusion）在肿瘤性与感染性疾病中较为常见。血流动力学不稳定及存在心脏压塞性积液（tamponading effusion）的患者需行强制性干预。手术可选方案包括：心包穿刺术（pericardiocentesis）、剑突下心包造口术（subxiphoid pericardiostomy）及心包开窗术（pericardial window）。其中心包开窗术已被证实复发率更低，但该术式仍在不断改良，以提升无复发生存率并降低术后并发症发生率。本文介绍一种新颖简便的改良术式：将覆盖于上腔静脉与右心房表面的心包开窗游离缘缝合固定于胸壁，以最大程度降低复发风险。随访结果显示本改良术式无复发病例，而传统术式的复发率为3.5%。