Parasternal thoracotomy: a new minimally invasive approach to the pericardium

Pericardiectomy is the preferred surgical procedure for the treatment of pericardial effusions with cardiac tamponade. Surgery is indicated in all cases of recurrent effusions after pericardiocentesis. In the literature, the most frequently used surgical procedure is subtotal pericardiectomy. More recently, minimally invasive techniques have allowed a reduction of morbidity compared to traditional procedures. Aim of this paper is to describe a new minimally invasive pericardiectomy technique and to document the results in a series of six cases. Six dogs underwent complete blood and urine tests, ultrasound examination, pericardiocentesis and CT scan. In all cases the pericardiectomy was performed via a left parasternal thoracotomy through the eleventh intercostal space. All the portions of resected pericardium were measured and histologically examined. Four dogs had a neoplastic mass at the base of the heart and no recurrence of the pericardial effusion. Two dogs had an inflammatory disease (pericarditis) and presented a clinically relevant pleural effusion after surgery, that required additional treatments. All dogs were discharged 24 hours after surgery. Parasternal pericardiectomy may be a good option for the minimally invasive treatment of recurrent pericardial effusions, particularly in the presence of neoplastic lesions of the heart base. The morbidity of the approach is similar to that of other known procedures but it is potentially faster and easier to perform. No dedicated instrumentation is required.

Additional Info

  • Authors: 1 Frizzi M., 1 D’Ettorre P., 2 Bertolini G., 2 Angeloni L.
  • Authors note: 1 Dipartimento di chirurgia, Clinica Veterinaria San Marco, Padova | 2 Dipartimento di diagnostica per immagini, Clinica Veterinaria San Marco, Padova
  • Year: 2018
  • Reference: Veterinaria Year 32, n. 1, February 2018
  • Pages: 1 - 8
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