What is the role of a video-assisted thoracoscopy in the treatment of cardiac tamponade?

Updated: Nov 28, 2018
  • Author: Chakri Yarlagadda, MD, FACC, FSCAI, FASNC, CCDS; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

In a study of 15 patients with cardiac tamponade, Monaco et al found that a modified, video-assisted thoracoscopic procedure seemed to be a feasible treatment for the condition. [26]

Using a right hemithoracic approach, the investigators employed a 15-mm trocar in the fourth right intercostal space of the anterior axillary and a 10-mm trocar in the seventh right intercostal space of the median axillary line.

Utilization of a 5-mm optic allowed two instruments, for the optic and for the endoscopic forceps, to be employed simultaneously using one trocar; this left the second trocar available for dissecting scissors. All patients underwent a pericardial resection equal to that achievable via an anterolateral thoracotomy.

The pericardial effusion was effectively drained in all patients, with no intraoperative mortality or perioperative morbidity encountered.


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