Systematic review of percutaneous interventions for malignant pericardial effusion.

Abstract

The present systematic review assessed the safety and efficacy of percutaneous interventions for malignant pericardial effusion (MPE), with primary endpoint of recurrence of pericardial effusion. Electronic searches of six databases identified thirty-one studies, reporting outcomes following isolated pericardiocentesis (n=305), pericardiocentesis followed by extended catheter drainage (n=486), pericardial instillation of sclerosing agents (n=392) or percutaneous balloon pericardiotomy (PBP) (n=157). Isolated pericardiocentesis demonstrated a pooled recurrence rate of 38.3%. Pooled recurrence rates for extended catheter drainage, pericardial sclerosis and PBP were 12.1%, 10.8% and 10.3%, respectively. Procedure-related mortality ranged from 0.5-1.0% across the percutaneous interventions. Although isolated pericardiocentesis can safely deliver immediate symptomatic relief, subsequent catheter drainage or sclerotherapy are required to minimize recurrence. PBP has been shown to be highly effective and may be particularly useful in managing recurrent effusions. Ultimately, the choice of intervention must be based on the clinical status of patients, their underlying malignancy and the expertise available.

• Authors: Sohaib A Virk, David Chandrakumar, Claudia Villanueva, Hugh Wolfenden, Kevin Liou, Christopher Cao
• Journal: Heart (British Cardiac Society) (Heart) Vol. 101 Issue 20 Pg. 1619-26 (Oct 2015) ISSN: 1468-201X [Electronic] England
• PMID: 26180077 (Publication Type: Journal Article, Review, Systematic Review)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Topics

• Heart Neoplasms (complications)
• Humans
• Pericardial Effusion (etiology, therapy)
• Pericardiocentesis (methods)
• Pericardium (surgery)
• Sclerotherapy (methods)