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Limitations of Surgical Methods of Pericardial Drainage: Title and subTitle BreakEchocardiographic Observations FREE

Premindra A. N. Chandraratna, MD; Wilbert S. Aronow, MD
[+] Author Affiliations

Reprint requests to Division of Cardiology, Long Beach Veterans Administration Hospital, 5901 E Seventh St, Long Beach, CA 90822 (Dr Chandraratna).


JAMA. 1979;242(10):1062-1063. doi:10.1001/jama.1979.03300100040020
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To assess the efficacy of surgical methods of pericardial drainage in preventing the accumulation of pericardial effusion, we performed M-mode and cross-sectional echocardiograms in 26 patients before and one week after the creation of a pericardial window or leaving the pericardium open after cardiac surgery. A pericardial window was created in six patients (group 1) who had pericardial effusions. Group 2 consisted of 20 patients who had heart surgery. Echocardiography disclosed moderate or large pericardial effusions preoperatively in all group 1 patients but in none of the group 2 patients. Following operation, three of the group 1 patients had complete clearing of pericardial effusion, while three showed reaccumulation. In group 2, thirteen patients had either no effusion or a small effusion. Seven patients had moderate or large pericardial effusions that were located posterior to the heart; only one had an anterior pericardial effusion. Cross-sectional echocardiography showed posterior loculation of effusion in six of the seven patients. Pericardial drainage is not always effective in preventing accumulation of pericardial effusions.

(JAMA 242:1062-1063, 1979)

REFERENCES

Hardy JD (ed): Rhoads Textbook of Surgery . Philadelphia, JB Lippincott Co, 1977;, p 1517.
Hochberg MS, Merrill WH, Gruber M, et al:  Delayed cardiac tamponade associated with prophylactic anticoagulation in patients undergoing coronary bypass grafting: Early diagnosis with two-dimensional echocardiography . J Thorac Cardiovasc Surg 75:777-781, 1978;.
Jones MR, Nine DL, Attas M, et al:  Late isolated left ventricular tamponade: Clinical, hemodynamic, and echocardiographic manifestations of a previously unreported postoperative complication . J Thorac Cardiovasc Surg 77:142-146, 1979;.

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Hardy JD (ed): Rhoads Textbook of Surgery . Philadelphia, JB Lippincott Co, 1977;, p 1517.
Hochberg MS, Merrill WH, Gruber M, et al:  Delayed cardiac tamponade associated with prophylactic anticoagulation in patients undergoing coronary bypass grafting: Early diagnosis with two-dimensional echocardiography . J Thorac Cardiovasc Surg 75:777-781, 1978;.
Jones MR, Nine DL, Attas M, et al:  Late isolated left ventricular tamponade: Clinical, hemodynamic, and echocardiographic manifestations of a previously unreported postoperative complication . J Thorac Cardiovasc Surg 77:142-146, 1979;.
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