ROLE OF THE PERICARDIOSCOPY IN THE TREATMENT OF PERICARDIAL EFFUSION

Yulia Pisklova

Abstract


In recent years surgical treatment of pericardial effusion has been favoured by mini-invasive interventions. Pericardioscopy supplements it. In the literature actively discusses its expediency, efficiency and informativeness.

Aim of the study. Analyze our experience of using pericardioscopy during surgical treatment of pericardial effusion using mini-invasive interventions.

Materials and methods. From 2000 to 2017, 92 patients with pericardial effusion were operated in our clinic using mini-invasive interventions. Pericardioscopy was used in 72 (78.26 %) cases. In 32 (44.44 %) pericardioscopy was performed with subxiphoid pericardiotomy, in 40 (55.56 %) – with thoracoscopy on the right or left side.

Results and discussion. The use of pericardioscopy has allowed to significantly reduce the number of idiopathic pericarditis from 20.0 % to 5.56 % and increase the informativeness of the minimally invasive interventions by 14.44 % (χ2 = 4.11, with ν = 1, α = 5 %). There is no reliable difference in the number of relapses of the disease.

Conclusions. The use of pericardioscopy during mini-invasive interventions is safe and effective. The method of choice in most cases is subxiphoid non-pleural pericardiotomy with pericardioscopy.


Keywords


pericarditis; pericardioscopy; surgical treatment; minimally invasive

Full Text:

PDF

References


Imazio, M. (2012). Treatment of recurrent pericarditis. Expert Review of Cardiovascular Therapy, 10 (9), 1165–1172. doi: http://doi.org/10.1586/erc.12.101

Giryalevskii, S. R. (2004). Diagnostika i lechenie zabolevanij perikarda: sovremennye podhody, osnovannye na dokazatelnoi informacii i klinicheskom opyte [Diagnosis and treatment of pericardial diseases: modern approaches based on evidence and clinical experience]. Moscow: Media Sfera, 132.

Arutyunov, G. P. (2006). Perikardit. Sovremennye problemy diagnostiki i lecheniya [Pericarditis. Modern problems of diagnosis and treatment]. Heart, 8, 384–400.

Sugak, A. B. (2009). Perikardityi: etiologiya, klassifikatsiya, klinika, diagnostika, lechenie. Chast 1 [Pericarditis: etiology, classification, clinic, diagnosis, treatment. Part 1]. Current pediatrics, 8 (2), 77–84.

Imazio, M., Adler, Y. (2012). Management of pericardial effusion. European Heart Journal, 34 (16), 1186–1197. doi: http://doi.org/10.1093/eurheartj/ehs372

Sugak, A. B., Alekseeva, E. I. (2009). Perikardityi: etiologiya, klassifikatsiya, klinika, diagnostika, lechenie. Chast 2 [Pericarditis: etiology, classification, clinic, diagnosis, treatment. Part 2]. Current pediatrics, 8 (3), 76–81.

Rumbesht, V. V., Diuzhikov, A. A., Kislitskii, A. I., Mozhaev, I. V., Galin, V. A., Mozhaev, N. N. et. al. (2008). Vozmozhnosti differentsialnoy diagnostiki perikarditov neyasnogo proishozhdeniya [Differential diagnostics possibilities for pericarditis with unclear genesis]. Cardiology and Cardiovascular Surgery, 6, 64–66.

Azam, S., Hoit, B. D. (2010). Treatment of Pericardial Disease. Cardiovascular Therapeutics, 29 (5), 308–314. doi: http://doi.org/10.1111/j.1755-5922.2010.00151.x

Lilly, L. S. (2013). Treatment of Acute and Recurrent Idiopathic Pericarditis. Circulation, 127 (16), 1723–1726. doi: http://doi.org/10.1161/circulationaha.111.066365

Gumrukcuoglu, H. A., Odabasi, D., Akdag, S., Ekim, H. (2011). Management of Cardiac Tamponade: A Comperative Study between Echo-Guided Pericardiocentesis and Surgery–A Report of 100 Patients. Cardiology Research and Practice, 2011, 1–7. doi: http://doi.org/10.4061/2011/197838

Haponiuk, I., Kwasniak, E., Chojnicki, M., Jaworski, R., Steffens, M., Sendrowska, A. et. al. (2015). Minimally invasive transxiphoid approach for management of pediatric cardiac tamponade – one center’s experience. Videosurgery and Other Miniinvasive Techniques, 10 (1), 107–114. doi: http://doi.org/10.5114/wiitm.2014.47690

Sulimanov, R. R., Sulimanov, R. A. (2013). Sravnitelnyiy analiz maloinvazivnyih hirurgicheskih metodov lecheniya vyipotnogo perikardita [Comparative analysis of minimally invasive surgical methods for treating effeminate pericarditis]. Bulletin of Novgorod State University, 71 (1), 47–50.

Mayosi, B. M. (2009). Interventions for tuberculous pericarditis (review). Cape Town: Wiley, 22.

Aivazyan, S. A., Medvedev, A. P., Sidorov, M. A., Nemirova, S. V., Rybinsky, A. D., Kosonogov, A. Ya. (2011). Perikardioskopiya v differentsialnoy diagnostike i lechenii ekssudativnyih perikarditov [Pericardioscopy in differential and treatment of pericardial effusion]. Modern Technologies in Medicine, 2011, 62–65.

Nikonenko, A. S., Zavgorodniy, S. N., Gubka, A. V., Golovko, N. G., Klimenko, A. V., Osaulenko, V. V. et. al. (2011). Hirurgicheskoe lechenie bolnyih ostryim ekssudativnyim perikarditom i ugrozoy razvitiya tamponadyi serdtsa s primeneniem miniinvazivnyih tehnologiy [Surgical treatment of patients with acute exudative pericarditis and threat of development of cardiac tamponade with the use of minimally invasive technologies]. Modern medical technologies, 3-4, 449–450.

Seterovic, P. M., Ristic, A. D., Maksimovic, R., Tatic, V., Ostojic, M., Kanjuh, V. (2003). Diagnostic Value of Pericardial Biopsy: Improvement With Extensive Sampling Enabled by Pericardioscopy. Circulation, 107 (7), 978–983. doi: http://doi.org/10.1161/01.cir.0000051366.97361.ea

Adler, Y., Charron, P., Imazio, M., Badano, L., Barón-Esquivias, G., Bogaert, J. et. al. (2015). 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. European Heart Journal, 36 (42), 2921–2964. doi: http://doi.org/10.1093/eurheartj/ehv318

Khandaker, M. H., Espinosa, R. E., Nishimura, R. A., Sinak, L. J., Hayes, S. N., Melduni, R. M., Oh, J. K. (2010). Pericardial Disease: Diagnosis and Management. Mayo Clinic Proceedings, 85 (6), 572–593. doi: http://doi.org/10.4065/mcp.2010.0046

Maisch, B., Rupp, H., Ristic, A., Pankuweit, S. (2013). Pericardioscopy and epi- and pericardial biopsy—a new window to the heart improving etiological diagnoses and permitting targeted intrapericardial therapy. Heart Failure Reviews, 18 (3), 317–328. doi: http://doi.org/10.1007/s10741-013-9382-y

Khandaker, M. H., Espinosa, R. E., Nishimura, R. A., Sinak, L. J., Hayes, S. N., Melduni, R. M., Oh, J. K. (2010). Pericardial Disease: Diagnosis and Management. Mayo Clinic Proceedings, 85 (6), 572–593. doi: http://doi.org/10.4065/mcp.2010.0046




DOI: http://dx.doi.org/10.21303/2504-5679.2018.00692

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 Yulia Pisklova

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2504-5679 (Online), ISSN 2504-5660 (Print)