• Journal of Chest Surgery
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• v.28 no.5
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• pp.487-490
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• 1995

We have experienced the 37 patients of pericardial effusion during last 8 years[1986-1993 . They were 17 male and 20 female patients, and their age range was 6months to 80 years.The causes of this pericardial effusion were 10 cases of tuberculosis, 7 cases of malignancy, 2 cases of acute pyogenic infection, 2 cases of postpericardiotomy pericardial effusion, 2 cases of trauma, 1 case of congenital heart disease, 1 case of SLE, and other 12 cases of unknown origin. All patients, except one, were managed by pericardiotomy with subxiphoid tube drainage. One case was managed by pericardiectomy. After operation, their symptoms and sign were dramaticaly improved. However, 3 patients were died postoperatively. Two of them were died of respiratory failure. One of them was died 28 months later with unrelated cause. They have already far advanced lung cancer. We conclude that the pericardiotomy with subxiphoid tube drainage was effective treatment in the patients with pericardial effusion.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.16-21
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• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Journal of Veterinary Clinics
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• v.34 no.6
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• pp.437-440
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• 2017

A five-month-old, male Domestic Korean shorthair was referred to our hospital with a history of lethargy, anorexia, and globoid cardiac silhouette on thoracic radiography. Physical examination showed dehydration and anemia was revealed on blood analysis. On thoracic radiography and echocardiography, the patient showed pericardial effusion and ultrasound-guided pericardiocentesis was performed. A Rivalta test of the pericardial effusion showed a positive result. As the patient had recurrent pericardial effusion, pericardiectomy was performed. He was tentatively diagnosed with wet form feline infectious peritonitis (FIP) and treated with Polyprenyl immunostimulant (PI). Neurological signs were eventually seen and he was euthanized. Histopathologic changes with markedly expanded neutrophils, lymphocytes, plasma cells, and macrophages with fibrous connective tissue and collagenous fibers were detected. Immunohistochemistry for FIP antigen was performed and results showed FIPV-positive multifocal aggregates of cells. Pericardial effusion is an atypical condition in cats with FIP, but can be presented. This case report describes FIP with pericardial effusion in a cat, in which definitive diagnosis of FIP was done using biopsy via pericardiectomy.

• Korean Journal of Veterinary Research
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• v.58 no.2
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• pp.115-118
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• 2018

A 13-year-old spayed female Miniature Schnauzer was presented with complaints of intermittent syncope. Pericardial effusion was confirmed based on the physical examination, thoracic radiographs and echocardiography. Subsequently, prompt pericardiocentesis was performed. Clinical abnormalities were immediately improved after pericardiocentesis. However, the clinical signs associated with acute collapse recurred. After the second pericardiocentesis, thoracic radiographs revealed pleural effusion, and the clinical signs resolved rapidly. The dog underwent pleural aspiration. Analysis of pleural fluid revealed almost similar features as the previous pericardial fluid. It was possible that a pericardial-pleural fistula was created during the pericardiocentesis. The pericardial and pleural effusion disappeared after the procedures.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1049-1053
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• 1995

Although neoplastic involvement of the pericardium is frequently present postmortem, cardiac manifestations before death are uncommon, and cardiac tamponade as the initial presentation of cancer is rare. We are presenting a metastatic pericardial tumor with cardiac tamponade of unknown primary neoplasm. The patient brought to hospital in a state of unconscious. The chest x-ray film showed cardiomegaly with a globular heart shape and right pleural effusion. We underwent an anterior thoracotomy and pericardial window was created. The histopathologic finding of pericardium, pleural and pericardial effusion show a metastatic adenocarcinoma. The patient subsequently received adjuvent radiotherapy and chemotherapy, but he expired on the postoperative 132 day.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.702-705
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• 2006

Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.397-403
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• 1991

From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.366-372
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• 1988

Cardiac tamponade occurring after open heart surgery is a rare, but fatal complication necessitating urgent drainage, though postoperative pericardial effusion is common. Two-dimensional echocardiographic study provides excellent postoperative visualization of pericardial effusion. Catheter insertion guided by two-dimensional echocardiography has been used to accomplish nonoperative drainage of symptomatic postoperative pericardial effusion in 4 cases. This technique offers simplicity, safety, and cost effectiveness.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.153-156
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• 2020

A 14-year-old intact female Cocker Spaniel dog, weighing 6.8 kg, presented with chief complaints of severe cough, dyspnea, anorexia, and exercise intolerance. It had the characteristics of a blood clot, the evidence of mitral regurgitation, a high left atrial/aortic root ratio, and pericardial effusion with a left atrial rupture due to myxomatous mitral valve degeneration (MMVD) was strongly suspected. Traditional therapy (pimobendan, furosemide, enalapril, and spironolactone) for heart failure with MMVD was provided twice a day orally, and partial pericardiectomy was performed for pericardial effusion. The medical prescriptions for MMVD were continued, and the patient's heart disease was well-controlled. However, it suddenly died 3 months after the operation.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.392-395
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• 2005

Primary pericardial mesothelioma is extremely rare and the incidence is low among the mesotheliomas that originate from other parts of the body. The prognosis of the tumor is unfavorable due to its late presentation, difficulties in early diagnosis and complete resection, and the limited treatment options. Herein, we report a case of pericardial mesothelioma. The patient is a 55-year-old woman who presented with chronic cough and dyspnea. During the examination, pericardial effusion was found and pericardial window formation was followed. She visited our hospital because of persistent dyspnea, with right shoulder and chest pain. Four discrete masses were discovered in the chest CT. CT guided-fine needle aspiration biopsy was negative for malignancy. Right exploratory thoracotomy and partial resection of 3${\times}$3 cm mass abutting pericardium was performed and was histologically diagnosed as malignant mesothelioma, biphasic type. Pericardial mesothelioma is rare, but it should be remembered as an important differential diagnosis in patients with persistent pericardial effusion and symptoms of dyspnea and constrictive pericarditis.