How is palliation provided in case of pericardial effusion?

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Pericardial effusion is the collection of fluid in the pericardial cavity, surrounding the heart.

The pericardium is a thin walled sac containing the heart. With invasion by tumor, fluid builds up in the sac and presses on the heart. As the pressure increases, filling of the heart with blood is impeded and the cardiac output (the volume of blood which the heart pumps in one minute) decreases. If fluid accumulation continues, tamponade (a form of heart failure) and death ensue.

Best treatment of this problem is by removing a portion of the pericardium surgically, thus allowing the fluid to drain out of the sac, reducing the pressure in the pericardium. There are a number of techniques to do this. My preference is thoracoscopic pericardiotomy, a procedure performed under general anesthesia through three small incisions using video-assisted techniques.

Other surgeons prefer pericardiotomy through a standard open thoracotomy incision, or through a subziphoid incision.

Some cardiologists are treating pericardial effusion by balloon techniques or by instilling chemicals into the pericardial sac.

Physicians can access a full text chapter on this topic in Cancer Management: A Multidisciplinary Approach 2nd Edition by following this link
URL http://www.cancernetwork.com and clicking on Fluid Complications in the left hand column. You will need to register in with a physician ID number.

For a more extensive discussion of this topic Pericardial resection

For more information on Thoracoscopic pericardiectomy

For more information on malignant pericardial effusion: Malignant pericardial effusion

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