%0 Journal Article
%T Mediastinoscope-controlled parasternal fenestration of the pericardium: definitive surgical palliation of malignant pericardial effusion
%A Imre Toth
%A Geza Szucs
%A Tamas F Molnar
%J Journal of Cardiothoracic Surgery
%D 2012
%I BioMed Central
%R 10.1186/1749-8090-7-56
%X The standard armamentarium of the Carlens collar mediastinoscopy procedure was utilized in a Chamberlain parasternal approach of the pericardial sac. The laterality of approach was decided based upon the pleural involvement, as tumor-free pericardiopleural reflection is required. A pericardio-pleural window at least 3£¿cm in diameter was created. From January 2000 to December 2009, 22 cases were operated on with mediastinoscope-controlled parasternal fenestration (MCPF). Considering the type of the primary tumor, there were 11 lung cancer, 6 breast cancers, 2 haematologic malignancies and in 3 patients the origin of malignancy could not be verified.There were no operative deaths. We lost one patient (4.5%) in the postoperative hospital period. All of the surviving patients had a minimum of 2£¿months of symptom-free survival. We detected transient recurrence of MPE in one patient (4.5%) 14£¿days after the MCPF, which disappeared spontaneously after 24 hours.The MCPF offers a real alternative in certain cases of pericardial effusion. We recommend this method especially for the definitive surgical palliation of MPE.
%K Pericardial fenestration
%K Pericardial effusion
%K Malignant effusion
%U http://www.cardiothoracicsurgery.org/content/7/1/56/abstract