Surgical management of cardiac tamponade: Is left anterior minithoracotomy really safe and effective?

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 ۶۱ patients (۳۷ males and ۲۴ females) with an average age of ۶۱.۸۰ ± ۱۶.۳۲ years. All patients underwent emergency surgery due to the presence of cardiac tamponade. Results: Cardiac tamponade was caused by a benign disease in ۵۷.۴۰% of patients. In cancer patients group, lung cancer, breast cancer and malignant pleural mesothelioma were the most common neoplasms (۱۷-۲۷, ۸۷%). The average preoperative size of pericardial effusion at M-۲D echocardiography was ۳۰.۱۵ ± ۵.۸۷ mm. Postoperative complications were observed in ۱۱ patients (۱۸%). The reoperation rate was ۳.۳% (۲ patients) due to relapsed cardiac tamponade. ۳۰-day mortality rate was ۳.۳%. Overall cumulative survival was ۲۹.۹ ± ۲۰.۱ months. Twenty-nine patients (۴۷.۵%) 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 < ۰.۰۰۱) 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.

کلیدواژه ها:

Cardiac tamponade ، Minithoracotomy ، Pericardial malignancies ، Overall survival