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Catheter drainage of the pericardium: its safety and efficacy.

A retrospective chart review identified 46 consecutive patients who underwent catheter drainage of the pericardium over 3 years. Cardiac tamponade was present in the majority of patients, and the underlying cause was tumour metastasis in 72%. Pericardial catheterization was accomplished by the Seldinger technique using the subxiphoid approach. Catheter insertion was successful in 42 of the 46 patients, and in only 1 was there a serious complication. The mean duration of catheter drainage was 3 days. The pericardial space was successfully drained in all but one patient, who subsequently required surgery. Intrapericardial chemotherapy was administered in 27 patients. There was no instance of catheter-associated sepsis. Supraventricular arrhythmias occurred in 19% of patients, but all were managed medically. There were no late complications attributable to the period of drainage. The authors conclude that catheter drainage of the pericardium is a safe and effective means of providing definitive drainage of the pericardial space.