Thoracoscopic approach for the pericardium.

The technique of video-assisted thoracic surgery (VATS) offers a new approach for management of effusive diseases of the pericardium. By the thoracoscopic approach, which can be performed through either the right or left chest cavity, an extensive pericardiectomy equivalent to one performed through a thoracotomy can be performed. Patients with benign effusive pericarditis, malignant pericardial effusions with a good prognosis, post-radiation pericarditis, purulent pericarditis, and delayed tamponade after open cardiac procedures can be optimally managed by video-assisted techniques.