Percutaneous pericardiotomy with balloon catheter in the treatment of malignant pericardial effusion in dogs

INTRODUCTION: Cardiac tamponade is an emergency clinical condition both in man and the dog. Neoplastic pericardial effusion caused by primary or metastatic tumors is one of the most frequent causes in the dog. The frequent relapses after pericardiocentesis have led to developing different procedures for pericardial removal or fenestration to improve the quality of life in both terminal and treated patients. The often critical condition of these patients calls for procedures causing as little surgical stress as possibile, which is the case of percutaneous pericardial balloon dilatation. We report our experience with this procedure in the first two dogs whose long-term follow-up is available. MATERIAL AND METHODS: Dogs need a short general anesthesia for restraining problems, while in man a slight sedation is sufficient. The anatomy being different, the percutaneous approach is intercostal in the dog and transdiaphragmatic in man. Echocardiographic guidance and fluoroscopic control are necessary during the procedure in both species. We report the clinical history of two dogs with neoplastic pericardial effusion, primary in one case and metastatic in the other. Both dogs were treated with pericardial balloon dilation. DISCUSSION AND CONCLUSIONS: Our experience in the dog and in man shows that percutaneous pericardial balloon dilation causes less patient stress than thoracotomic or thoracoscopic pericardiectomy. Moreover, the surgical cost is lower and hospitalization time is reduced. On the other hand, the surgical methods permit bioptic sampling and better and more thorough studies of chest structures. We suggest percutaneous pericardiectomy as a valid alternative to surgery to treat chronic benign pericarditis, which obviously needs further confirmation from dedicated studies.