Percutaneous Pericardial Drainage: A Reliable and Efficient First-Line Treatment in Case of Non-Iatrogenic Pericardial Effusion

Author(s): Delon C, Bouisset F, Porterie J, Biendel C, Blanco S, Roncalli J, Grunenwald E, Carrié D, Elbaz M, Galinier M, Lairez O, Delmas C

Background: Pericardial effusion can be a life-threatening condition and urgent drainage is then life-saving but no consensus exists as to the preferential use of a percutaneous drainage (PCD) or a surgical drainage (SD) approach.

Method and Results: All patients admitted for symptomatic pericardial effusion in 2018 in our tertiary Intensive Cardiac Care Unit (Toulouse, France) were prospectively included. In- hospital complications, length of stay, 6-months mortality and recurrences have been collected and compared according to the procedure (PCD vs. SD). One hundred and twenty nine patients were admitted for pericardial effusion and 92 were drained: 54 (59%) and 38 (41%) by a surgical and percutaneous procedure, respectively. In- hospital complications were the same between the 2 procedures (7% for SD group and 15% for PCD; p = 0.39). However, duration of hospitalization was shorter for patients treated by PCD (5.9±4.4 versus 8.2±4.9 days; p = 0.02). Six-month mortality (22% for SD versus 37% for PCD; p = 0.12) or recurrences (11% for PCD versus 24% for SD; p = 0.11) were not different.

Conclusion: In case of symptomatic non-iatrogenic pericardial effusions, PCD is an efficient and reliable less invasive technique. Its possible and wide availability, and its shorter length of hospitalization justifies its use as first line therapy in trained team especially for cancer patients.