Malignant Pericardial Effusion
Treatment may be to control the symptoms of pericardial effusion and improve quality of life.
The goal of treatment is usually palliative, to relieve symptoms and improve quality of life. A large malignant pericardial effusion is controlled by draining the fluid.
Treatment options include the following:
A procedure to remove the extra fluid from the sac around the heart using a needle inserted through the chest wall. The doctor may use echocardiography to watch the movement of the heart and needle inside the chest. Removing the fluid can reduce pressure on the heart. In some patients, fluid may again collect in the sac around the heart after pericardiocentesis. A catheter (flexible tube used to put fluids into or take blood out of a vein) may be inserted and left in place so the fluid will keep draining. This procedure may be used instead of more serious surgery for patients with advanced cancer.
- Pericardial sclerosis
A procedure to close the pericardial space so fluid cannot collect in the sac around the heart. Fluid is first removed by pericardiocentesis. A drug or chemical is then injected through a catheter (flexible tube used to put fluids into or take blood out of a vein) into the pericardial space to cause it to close. Three or more treatments may be needed to completely close the pericardial space.
A procedure to insert a drainage tube. An incision (cut) is made in the chest and then in the pericardium and a drainage tube is put in place. This increases the amount of fluid that can be drained from the pericardium.
Surgery to remove part of the pericardium. This may be done to drain fluid quickly when cardiac tamponade occurs. This surgery is also called pericardial window.
- Balloon pericardiostomy
A catheter (flexible tube used to put fluids into or take blood out of a vein) with a balloon tip is inserted through the chest and into the pericardium. The balloon is then inflated to make the pericardial opening bigger. The balloon is then deflated and removed. The bigger opening allows the fluid to drain into the pleural cavity. This may be used when an effusion has recurred (come back) after pericardiocentesis or instead of more serious surgery.