Drainage par voie percutanée des épanchements péricardiques post-opératoires en chirurgie cardiaque

Objectives : Pericardial effusion frequently occurred in the post-operative period following cardiac surgery. The main risk is that it leads to cardiac tamponade. Open subxiphoid pericardial drainage is the classical treatment. The objective of this study is to assess the feasibility and effectiveness of the percutaneous pericardial drainage. Method: It is a retrospective study involving 197 patients from 1990 to 2008. All benefi ted from a percutaneous pericardial drainage (91,9% subxiphoïd approach and 8,1% left para-sternal) between 3 and 690 days after cardiac surgery by sternotomy . Pericardial effusion should measure at least 10mm in echography by subxiphoïd view to be drained with this technique. Results: No death directly related to the procedure has been reported. The percutaneous pericardial drainage was a success with 158 patients (80,2%). Failure of the drainage was observed with 22 patients (11,2%), because of a white puncture (7,1%) or a right ventricular puncture (4,1%). Recurrence of pericardial effusion occurred for 17 patients (8,6%). Mean duration of the drainage was 4 days. Conclusion: Percutaneous pericardial drainage is a simple option in the treatment of post-operative pericardial effusion. We consider this technique in fi rst intention when applicable and reserve the surgical drainage to its failures and complications.