surgical management of cardiac tamponade: is left anterior minithoracotomy really safe and effective?

Objective: cardiac tamponade is a life-threatening clinical entity that requires an emergency treatment. cardiac tamponade can be caused both by benign and malignant diseases. a variety of methods have been described for the treatment of these cases from needle-guided pericardiocentesis, balloon-based techniques to surgical pericardiotomy. the authors report their experience in surgical management of cardiac tamponade and an exhaustive review of literature. methods: this study involved 61 patients (37 males and 24 females) with an average age of 61.80 ± 16.32 years. all patients underwent emergency surgery due to the presence of cardiac tamponade. results: cardiac tamponade was caused by a benign disease in 57.40% of patients. in cancer patients group, lung cancer, breast cancer and malignant pleural mesothelioma were the most common neoplasms (17-27, 87%). the average preoperative size of pericardial effusion at m-2d echocardiography was 30.15 ± 5.87 mm. postoperative complications were observed in 11 patients (18%). the reoperation rate was 3.3% (2 patients) due to relapsed cardiac tamponade. 30-day mortality rate was 3.3%. overall cumulative survival was 29.9 ± 20.1 months. twenty-nine patients (47.5%) died during the follow up period. by dividing the population into two groups, group b (benign) and group m (malignant), there was a statistically significant difference (p < 0.001) in terms of survival. conclusion: in conclusions, anterior minithoracotomy for surgical treatment of cardiac tamponade has to be held into account in patients both with benign diseases and malignancies.