Percutaneous pericardial catheter drainage: report of 42 consecutive cases.

Test results of 42 consecutive patients with pericardial effusion treated with percutaneous pericardial drainage were analyzed. Intermittent (79%) or continuous (21%) drainage through a 60-cm pigtail catheter (No. 6Fr to 8Fr) was used. Clinical indications were urgent or semiurgent treatment of large (38%), life-threatening (24%), recurrent (21%) or acute (traumatic) (17%) pericardial effusion. Sixteen patients had a malignant cause for the effusion. Mean duration of use of the indwelling pericardial catheter was 3.5 days (range less than 1 day to 19 days). Two of the 9 catheters in patients on continuous drainage but only 1 of 33 catheters in patients on intermittent drainage became occluded. There was only 1 possible infective complication. Six patients had subsequent elective surgical intervention for persistent or recurrent effusion. Placement of an indwelling pericardial catheter guided by 2-dimensional echocardiography is safe and effective for initial treatment of selected pericardial effusions.