Abstract

MEDEROS CURBELO, Orestes Noel et al. Surgical treatment of acute and chronic collections of the pericardium. Rev Cubana Cir [online]. 2014, vol.53, n.2, pp.156-166. ISSN 0034-7493.

Introduction: chronic and acute collections of the pericardium often cause heart compression in chronic cases leading to disability and risk of death by acute cardiac tamponade. Objective: to describe the results of surgically treating patients who suffered pericardial collections in "Comandante Manuel Fajardo" hospital during the 1995 to 2012 period. Methods: across-sectional descriptive study of 24 surgical patients, 22 with acute pericardial collections and two with chronic pericardial collections. Results: the most frequent cause of acute pericardial effusions was acute idiopathic pericarditis (25 %). Chronic collections resulted from fibrotic pericarditis of unknown origin in 100 % of patients. The surgical procedure was excision of the pericardium and drainage of the acute collection through left sided thoracotomy or the subxyphoid pre-peritoneal route. In the case of malignancy, palliative resection was performed and in the case of traumatic heart injure, the treatment of choice was suture of this organ in all the cases. Constrictive pericarditis was managed by radical pericardiodectomy in 100 % of cases. Conclusions: the surgical treatment of acute and chronic collections of the pericardium allows draining through a pericardial opening created by thoracoscopy or subxyphoid preperitoneal route. The best technique in emergencies was left thoracotomy. In the chronic collections with fibrosis and heart failure symptoms, the radical pericardiodectomy performed by means of middle sternotomy offers the best results.

Keywords : pericardial collections; tamponade; pericardiocentesis.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )