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Clinical Features of the Patients with Recurrent Massive Pericardial Effusion: Single Center Experience

Year 2018, Volume: 40 Issue: 3, 233 - 237, 30.09.2018
https://doi.org/10.7197/223.vi.415818

Abstract

Objective:
In this study, we aimed to determine the clinical features
of patients with recurrent pericardial effusion. We also aimed to evaluate the
clinical course and the outcomes of the patients with recurrent pericardial effusion
who underwent percutaneous and surgical interventions.



Method: 22 patients with recurrent massive pericardial effusion were
retrospectively evaluated. We recorded the primary etiologies of effusion,
laboratory parameters, and time of the recurrence of effusion, type of the
pericardial drainage and also one year mortality of the patients after
pericardial drainage.



Results:
Mean age of the patients was 60±16 and 64% were
male. The most common cause was malignancy (31%) followed by idiopathic (27%),
postcardiotomy syndrome (13,5%), renal failure(13,5%), autoimmune disease
(10%), and heart failure (5%). Median recurrent time was 46 days (interquartile
range 16-78 days).  The characteristics
of the pericardial fluid at initial intervention consist of 59.5%
serohaemorrhagic, 27% serous and 13,5% 
hemorrhagic pericardial effusion . Majority of patients (73%) underwent
subxiphoid tube drainage and the remaining patients (27%) underwent
percutaneous pericardiocentesis in first intervention.  9 (40.9%) patients died in one year follow
up. Of the dead patients, 55.5% had malignity, 22.2% had postcardiotomy
syndrome and 22.2% had renal failure.



Conclusion:
The most common cause of death and recurrent
pericardial effusion was malignancy. Idiopathic recurrent pericarditis,
autoimmune disease and congestive heart failure are the most benign pathology
in which the patients had no mortality in a 1 year follow up period.

References

  • 1. Allen KB, Faber LP, Warren WH, et al. Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg 1999;67:437-40.2. Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015;36:2921–64.3. Larrey EL. New surgical procedure to open the pericardium in the case of fluid in the cavity. Clin Chir 1829;36:303–37.4. Dosios T, Theakos N, Angouras D, et al. Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy. Chest 2003;124:242-246.5.Tutar HE, Atalay S, Uysalel A, et al. Recurrent pericardial effusion due to gunshot wound of the heart in a hemodynamically stable child-a case report. Angiology 1999; 50: 337-40.6.Altintas G, Yasar E, Kadirogullari E, et al. A comparison of two surgical techniques for symptomatic pericardial effusion after cardiac surgery: subxiphoid open pericardial drainage and lateral thoracotomy. Turk Gogus Kalp Dama 2014;22(1):29–34.7. Yüksel V, Hüseyin S, Okyay A, et al. Erişkinlerde subksifoidal perikardiyostomi yöntemi ile perikardiyal efüzyon tedavisi. Turk Gogus Kalp Dama 2012;20(3):492-4968.Maisch B, Ristic´ AD, Pankuweit S, et al. Neoplastic pericardial effusion: efficacy and safety of intrapericardial treatment with cisplatin. Eur Heart J 2002;23:1625–31.
Year 2018, Volume: 40 Issue: 3, 233 - 237, 30.09.2018
https://doi.org/10.7197/223.vi.415818

Abstract

References

  • 1. Allen KB, Faber LP, Warren WH, et al. Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg 1999;67:437-40.2. Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC). Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2015;36:2921–64.3. Larrey EL. New surgical procedure to open the pericardium in the case of fluid in the cavity. Clin Chir 1829;36:303–37.4. Dosios T, Theakos N, Angouras D, et al. Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy. Chest 2003;124:242-246.5.Tutar HE, Atalay S, Uysalel A, et al. Recurrent pericardial effusion due to gunshot wound of the heart in a hemodynamically stable child-a case report. Angiology 1999; 50: 337-40.6.Altintas G, Yasar E, Kadirogullari E, et al. A comparison of two surgical techniques for symptomatic pericardial effusion after cardiac surgery: subxiphoid open pericardial drainage and lateral thoracotomy. Turk Gogus Kalp Dama 2014;22(1):29–34.7. Yüksel V, Hüseyin S, Okyay A, et al. Erişkinlerde subksifoidal perikardiyostomi yöntemi ile perikardiyal efüzyon tedavisi. Turk Gogus Kalp Dama 2012;20(3):492-4968.Maisch B, Ristic´ AD, Pankuweit S, et al. Neoplastic pericardial effusion: efficacy and safety of intrapericardial treatment with cisplatin. Eur Heart J 2002;23:1625–31.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Fatih Ada

Sadık Volkan Emren

Publication Date September 30, 2018
Acceptance Date September 14, 2018
Published in Issue Year 2018Volume: 40 Issue: 3

Cite

AMA Ada F, Emren SV. Clinical Features of the Patients with Recurrent Massive Pericardial Effusion: Single Center Experience. CMJ. September 2018;40(3):233-237. doi:10.7197/223.vi.415818