What is the role of pericardiotomy in the treatment of acute pericarditis?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Consider subxiphoid pericardiotomy for large effusions that do not resolve. This procedure may be performed under local anesthesia and has a lower risk of complications compared with pericardiectomy.

The European Society of Cardiology (ESC) 2004 guideline recommends percutaneous balloon pericardiotomy, which creates a pleuro-pericardial direct communication, allowing for drainage of fluid into the pleural space. [32] In large malignant pericardial effusions and recurrent tamponade, it appears to be a safe and effective (90-97%) intervention. [32] Consider percutaneous balloon pericardiotomy to prevent recurrence of neoplastic pericardial effusions (class IIb, level B evidence). [3]


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