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| - Surgical treatment of large pericardial effusions. Etiology and long-term survival
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| - From 1977 to 1988 60 patients were treated for large pericardialeffusion. The operation consisted of a small left anterior thoracotomy withformation of a pericardial window. In 28 patients (47%) the etiology was amalignant disease. Eight patients (29%) had malignant cells in thepericardial fluid and 23 patients (82%) had metastases to the pericardium.Seven patients (12%) had purulent pericarditis; in 4 cases Staphylococcuswas found. Of the remaining 25 patients, the etiology remained unknown in13. The 5-year survival rate was 60% among patients with nonmalignanteffusions. In patients with malignant effusions only 20% were alive after 2years. There were no deaths related to the operation. We conclude thatlarge pericardial effusions of unknown etiology can be safely treated witha small left anterior thoracotomy. This access gives optimal possibilitiesfor rapid diagnosis and treatment.
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