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A pericardial window is a cardiac surgical procedure to create a fistula – or "window" – from the pericardial space to the pleural cavity. [1] The purpose of the window is to allow a pericardial effusion or cardiac tamponade to drain from the space surrounding the heart into the chest cavity. [2]
Pericardiectomy should not be used if more minor procedures are more appropriate, such as a pericardial window. [6] Pericardiectomy may not be appropriate for patients who already have a poor prognosis, as its medical benefit is reduced. This is because pericardiectomy has a higher rate of complications and a higher mortality. [6]
The typical signs of post-pericardiotomy syndrome include fever, pleuritis (with possible pleural effusion), pericarditis (with possible pericardial effusion), occasional but rare pulmonary infiltrates, and fatigue. [1] [2] Cough, pleuritic or retrosternal chest pain, joint pain and decreased oxygen saturation can also be seen in some cases. [1]
Pericardiocentesis is a one-off procedure, which may not be appropriate for long-term drainage. In cases where longer term drainage is needed, the cardiothoracic surgeon can create a pericardial window. This involves the removal of a section of the pericardium, and the placement of a chest tube. [citation needed]
Early in a coronary artery bypass operation, during vein harvesting from the legs (left of image) and the establishment of cardiopulmonary bypass by placement of an aortic cannula (bottom of image). The perfusionist and heart-lung machine are on the upper right. The patient's head (not seen) is at the bottom.
It consists of fever, pleuritic pain, pericarditis and/or pericardial effusion. Dressler syndrome is also known as postmyocardial infarction syndrome [1] and the term is sometimes used to refer to post-pericardiotomy pericarditis. It was first characterized by William Dressler at Maimonides Medical Center in 1956. [2] [3] [4]
Pericardial effusion – The serous pericardium normally contains fluid that reduces friction, but an abnormal accumulation of fluid in the pericardium is called a pericardial effusion. The list of causes is lengthy but includes pericarditis, rheumatic diseases (e.g., systemic lupus erythematosus), trauma, and blood from myocardial rupture.
The pericardium (pl.: pericardia), also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. [1] It has two layers, an outer layer made of strong inelastic connective tissue (fibrous pericardium), and an inner layer made of serous membrane (serous pericardium).