Clinical and Echocardiographic Characteristics of Patients With Cardiac Tamponade and its Survival Prognostic Factors

Cardiac tamponade nearly always requires urgent intervention, but the optimal management of pericardial effusion is still controversial. The aim of our study was to introduce the profile and treatment results of patients with tamponade in our referral heart center.

From November 2010 to November 2014, our retrospective study was performed on 220 patients with tamponade. All the clinical and echocardiographic findings of the patients, as well as their operative and follow-up data, were recorded and analyzed.

The overall prevalence of tamponade relative to the entire study population undergoing heart surgery was 8.5%. There were 106 men and 114 women at a mean age of 55.5 years (range = 5–99). The most common causes of tamponade were cardiac diseases (21%), malignancy (20.4%), unknown (20.4%), chronic renal failure (15%), and post-cardiac surgery complications (10.5%). The approaches for pericardial effusion drainage were the subxiphoid approach (97.7%), mini-thoracotomy (1.4%), and percutaneous pericardiocentesis (0.9%). The intraprocedural mortality rate was zero, the mortality rate during hospital stay was 4.5%, and the recurrence rate was 9.1%. Patients with primary sanguineous pericardial effusion, malignant etiologies of tamponade, and malignant pericardial effusion had significantly poor survival. The survival rates at 1 month, 1 year, 2 years, and 3 years were 87.1%, 67.7%, 64.5%, and57.2%, respectively.

We found an association between left pleural effusion and small amounts of pericardial effusion, hence the necessity of more attention in the echocardiographic evaluation of these patients. The subxiphoid approach for pericardial effusion drainage is a safe and simple procedure associated with relatively lower postoperative complications, mortality, and recurrence rate. Sanguineous pericardial effusion is concomitant with poor prognoses.