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Cardiac surgical procedure
A pericardial window is a
cardiac surgical procedure to create a
fistula – or "window" – from the
pericardial space to the
pleural cavity .
[1] The purpose of the window is to allow a
pericardial effusion or
cardiac tamponade to drain from the space surrounding the
heart into the
chest cavity .
[2]
Uses
Pericardial window may be used to treat
pericardial effusion and
cardiac tamponade .
[2]
[3] It is the most common procedure to treat pericardial effusion, particularly if caused by
cancer .
[4] Untreated, these can lead to
death . The pericardial window decreases the incidence of postoperative pericardial tamponade and new-onset
atrial fibrillation after
open-heart surgery .
[5]
Risks
Creation of a pericardial window is a major
surgical procedure .
[6] To remove
pericardial fluid , other more minor techniques should be considered first, such as
pericardiocentesis .
[4]
Technique
Pericardial window is usually performed under
general anaesthetic by a
cardiac surgeon . They may make an open
surgical incision of up to 10
cm .
[6] This is usually located below the
xiphoid process of the
sternum (sub-xiphoid).
[4] Alternatively, access may be gained
thoracoscopically with a smaller surgical incision.
[3]
[7] A small hole of between 1 cm and 2 cm is cut in the
pericardium , which is the membrane that surrounds the
heart .
[6] This allows for any
pericardial fluid and other fluid to escape from the pericardium.
[6]
History
Pericardial window was first performed by
Baron
Dominique Jean Larrey in
1829 .
[6]
[8]
Other animals
Pericardial windows are commonly used in
veterinary medicine to treat pericardial effusion.
[7] Whereas a sub-xiphoid skin incision is preferred in humans, a left para-xiphoid skin incision is preferred in
cats .
[9]
References
^ Stuart J. Hutchison (2008).
Pericardial diseases: clinical diagnostic imaging atlas . Elsevier Health Sciences. pp. 93–.
ISBN
978-1-4160-5274-6 . Retrieved 10 November 2010 .
^
a
b Ghavidel, Alireza Alizadeh; Hosseini, Saeid (2018-01-01), Maleki, Majid; Alizadehasl, Azin; Haghjoo, Majid (eds.),
"Chapter 37 - Principles of Cardiovascular Surgery" , Practical Cardiology , Elsevier, pp. 647–659,
doi :
10.1016/b978-0-323-51149-0.00037-7 ,
ISBN
978-0-323-51149-0 , retrieved 2020-12-02
^
a
b Laste, Nancy J (2009-01-01), Silverstein, Deborah C.; Hopper, Kate (eds.),
"Chapter 44 - Pericardial Diseases" , Small Animal Critical Care Medicine , Saint Louis: W.B. Saunders, pp. 184–188,
doi :
10.1016/b978-1-4160-2591-7.10044-x ,
ISBN
978-1-4160-2591-7 , retrieved 2020-12-02
^
a
b
c Fashoyin-Aje, Lola A.; Brahmer, Julie R. (2020-01-01), Niederhuber, John E.; Armitage, James O.; Kastan, Michael B.; Doroshow, James H. (eds.),
"59 - Malignancy-Related Effusions" , Abeloff's Clinical Oncology (Sixth Edition) , Philadelphia: Elsevier, pp. 863–873.e4,
doi :
10.1016/b978-0-323-47674-4.00059-1 ,
ISBN
978-0-323-47674-4 ,
S2CID
198374790 , retrieved 2020-12-02
^ Zhao J (Apr 2014).
"Does posterior pericardial window technique prevent pericardial tamponade after cardiac surgery?" . J Int Med Res . 42 (2): 416–26.
doi :
10.1177/0300060513515436 .
PMID
24553479 .
^
a
b
c
d
e Asensio, Juan A.; García-Núñez, Luis Manuel; Petrone, Patrizio; Duran, Dominic; Vara, Alexander D.; Weston, John S.; Gmora, Scott B.; Feinstein, Ara; Robinson, Donald (2008-01-01), Asensio, JIan A.; Trunkey, Donald D. (eds.),
"Cardiac Injuries" , Current Therapy of Trauma and Surgical Critical Care , Philadelphia: Mosby, pp. 304–315,
doi :
10.1016/b978-0-323-04418-9.50044-8 ,
ISBN
978-0-323-04418-9 , retrieved 2020-12-02
^
a
b Clarke, Dana L.; Culp, William T. N. (2015-01-01), Silverstein, Deborah C.; Hopper, Kate (eds.),
"Chapter 136 – Minimally Invasive Procedures" , Small Animal Critical Care Medicine (Second Edition) , St. Louis: W.B. Saunders, pp. 715–721,
doi :
10.1016/b978-1-4557-0306-7.00136-7 ,
ISBN
978-1-4557-0306-7 , retrieved 2020-12-02
^ Larrey, D. J. (1829).
"New surgical procedure to open the pericardium in case of fluid in its cavity" . Clinical Chir . 2 : 303–307.
^ van Nimwegen, S. A.; Kirpensteijn, J. (2014-01-01), Langley-Hobbs, Sorrel J.; Demetriou, Jackie L.; Ladlow, Jane F. (eds.),
"Chapter 42 – Thoracoscopy" , Feline Soft Tissue and General Surgery , W.B. Saunders, pp. 487–493,
doi :
10.1016/b978-0-7020-4336-9.00042-1 ,
ISBN
978-0-7020-4336-9 , retrieved 2020-12-02
External links