Ishida Shinichi, Yagami Kei, Fujita Takashi, Mutsuga Masato
Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, 5-161, Maebata-cho, Tajimi-City, Gifu 507-8532, Japan.
Department of Cardiac Surgery, Gifu Prefectural Tajimi Hospital, 5-161, Maebata-cho, Tajimi-City, Gifu 507-8532, Japan.
Int J Surg Case Rep. 2021 Jun;83:105962. doi: 10.1016/j.ijscr.2021.105962. Epub 2021 May 12.
Given that pericardial effusion may sometimes lead to cardiac tamponade and chronic heart failure, its management seems absolutely essential. In case of a poor response to medical therapy, surgical drainage of the effusion is required. Although some drainage procedures for pericardial effusion (e.g., temporary puncture, pericardiopleural drainage, and pericardioperitoneal drainage) are currently used in clinical practice, their long-term efficacy remains unclear.
We present a case of a 58-year old female with recurrent pericardial effusion secondary to systemic lupus erythematosus. Since she was relatively young and on steroids, long-term patency of pericardial fenestration needed to be insured without any device. Hence, we created 2 pericardial windows, pericardioperitoneal and pericardiopleural, via a single-incision subxiphoid approach to allow the effusion to drain into the abdominal and thoracic cavities.
It is important to efficiently manage pericardial effusion because it can lead to more serious conditions such as cardiac tamponade and chronic heart failure. Our technique, which involves making a small incision, can reduce the risk of recurrence.
Simultaneous creation of pericardioperitoneal and pericardiopleural windows is simple and can be feasibly performed to prevent the recurrence of pericardial effusion.
鉴于心包积液有时可能导致心脏压塞和慢性心力衰竭,其治疗显得至关重要。若药物治疗效果不佳,则需要进行心包积液的外科引流。尽管目前临床实践中使用了一些心包积液引流方法(如临时穿刺、心包胸膜腔引流和心包腹腔引流),但其长期疗效仍不明确。
我们报告一例58岁女性系统性红斑狼疮继发复发性心包积液的病例。由于患者相对年轻且正在使用类固醇药物,需要在不使用任何装置的情况下确保心包开窗术的长期通畅。因此,我们通过单一剑突下切口创建了两个心包窗口,即心包腹腔和心包胸膜腔窗口,以使积液排入腹腔和胸腔。
有效治疗心包积液很重要,因为它可能导致更严重的情况,如心脏压塞和慢性心力衰竭。我们的技术只需做一个小切口,可降低复发风险。
同时创建心包腹腔和心包胸膜腔窗口操作简单,可行以预防心包积液复发。