research
Surgical management of cardiac tamponade: Is left
anterior minithoracotomy really safe and effective?
- Publication date
- Publisher
Abstract
Objective: Cardiac tamponade is a life-threatening clinical entity that requires an emergency
treatment. Cardiac tamponade can be caused both by benign and malignant diseases. A
variety of methods have been described for the treatment of these cases from needle-guided
pericardiocentesis, balloon-based techniques to surgical pericardiotomy. The Authors report
their experience in surgical management of cardiac tamponade and an exhaustive review of
literature.
Methods: This study involved 61 patients (37 males and 24 females) with an average age of
61.80 ± 16.32 years. All patients underwent emergency surgery due to the presence of cardiac
tamponade.
Results: Cardiac tamponade was caused by a benign disease in 57.40% of patients. In
cancer patients group, lung cancer, breast cancer and malignant pleural mesothelioma were
the most common neoplasms (17-27, 87%). The average preoperative size of pericardial
effusion at M-2D echocardiography was 30.15 ± 5.87 mm. Postoperative complications were
observed in 11 patients (18%). The reoperation rate was 3.3% (2 patients) due to relapsed
cardiac tamponade. 30-day mortality rate was 3.3%. Overall cumulative survival was 29.9
± 20.1 months. Twenty-nine patients (47.5%) died during the follow up period. By dividing
the population into two groups, group B (benign) and group M (malignant), there was a
statistically significant difference (P<0.001) in terms of survival.
Conclusion: In conclusions, anterior minithoracotomy for surgical treatment of cardiac
tamponade has to be held into account in patients both with benign diseases and
malignancies.
Keywords: Cardiac tamponade, Minithoracotomy, Pericardial malignancies, Overall surviva