Palacios I F, Tuzcu E M, Ziskind A A, Younger J, Block P C
Department of Medicine, Massachusetts General Hospital, Boston 02114.
Cathet Cardiovasc Diagn. 1991 Apr;22(4):244-9. doi: 10.1002/ccd.1810220403.
We performed percutaneous balloon pericardial window (PBPW) in 8 patients (age 40 to 70 yrs; 4 men, 4 women) with malignant pericardial effusion and tamponade. Pericardial window was indicated because they continued to drain greater than 100 ml/day of pericardial fluid through the pigtail catheter for greater than or equal to 3 days. A 0.038 inch guidewire was advanced through the pigtail catheter into the pericardial space and then the catheter was removed. A 20 mm diameter, 3 cm long balloon dilating catheter was advanced to straddle the parietal pericardium. Manual inflations were performed until the waist produced by the pericardium disappeared. All patients tolerated the procedure well with minimal discomfort and with no complications. A left or bilateral pleural effusion occurred in all patients after PBPW. No patient developed recurrent pericardial tamponade at a mean follow-up of 6 +/- 2 months. Thus, PBPW is a useful and safe technique to avoid surgery in patients with malignant pericardial effusion and tamponade.
我们对8例（年龄40至70岁；4例男性，4例女性）恶性心包积液并心包填塞患者进行了经皮球囊心包开窗术（PBPW）。进行心包开窗术的指征是，他们通过猪尾导管持续引流出大于100毫升/天的心包积液，且持续时间大于或等于3天。一根0.038英寸的导丝通过猪尾导管推进到心包腔，然后移除导管。将一根直径20毫米、长3厘米的球囊扩张导管推进至横跨壁层心包。进行手动充气，直到心包产生的腰部消失。所有患者对该操作耐受良好，仅有轻微不适，且无并发症。PBPW术后所有患者均出现左侧或双侧胸腔积液。在平均6±2个月的随访中，无患者发生复发性心包填塞。因此，PBPW是一种有用且安全的技术，可避免恶性心包积液并心包填塞患者进行手术。
