Wang H.-J.Hsu K.-L.FU-TIEN CHIANGTseng C.-D.Tseng Y.-Z.Liau C.-S.2021-03-112021-03-1120020012-3692https://scholars.lib.ntu.edu.tw/handle/123456789/551796Objective: To investigate both the use of immediate or elective double-balloon pericardiotomy (DBP) in patients with a large amount of malignancy-related pericardial effusion, and the prognosis of this subgroup. Design: Observational study after DBP intervention. Setting: Tertiary referral center. Patients and interventions: Fifty patients with malignancy, mainly lung and breast cancer, who were admitted to our critical care unit with a large amount of pericardial effusion. All received echocardiographic-guided pericardiocentesis. Group 1 consisted of 12 patients (24%) who received immediate DBP, and group 2 consisted of 38 patients (76%) who received delayed DBP 2.5 ± 1.7 days later (mean ± SD) after emergency pericardiocentesis with pigtail catheter drainage. Measurements: After the procedure, and at 1 month, 3 months, and 6 months, echocardiography and chest radiography were performed to check for pneumothorax, pericardial effusion reaccumulation, or the appearance of pleural effusion after pigtail catheter removal. Main results: The procedure was successful and without recurrence in 44 patients (88%). Procedural complications were fever in 4 patients (33%) and 10 patients (26%) in group 1 and group 2, respectively (p = 0.72), and mild pneumothorax in 2 patients (17%) and 1 patient (3%) in group 1 and group 2, respectively (p = 0.14). Fifty percent of the patients died within 4 months, while 25% survived to 11 months. High serum calcium, a low albumin/globulin ratio, and positive results on pericardial effusion cytology were poor prognostic factors for long-term survival. Conclusion: Both immediate and delayed DBP are a safe and effective method of relieving large pericardial effusions in patients with cancer. Successful DBP without recurrence of pericardial effusion was achieved in 88% of all patients. Survival was related to the extent of the disease.Cancer; Cardiac tamponade; Percutaneous balloon pericardiotomy; Pericardial effusion; Pericardiocentesis[SDGs]SDG3adult; aged; article; breast carcinoma; calcium blood level; cancer survival; cause of death; clinical article; controlled study; cytology; echocardiography; female; human; intensive care unit; lung carcinoma; male; pericardial effusion; pericardiocentesis; pericardiotomy; pneumothorax; postoperative complication; priority journal; prognosis; safety; surgical technique; thorax radiography; treatment indication; treatment outcomejournal article10.1378/chest.122.3.893122260292-s2.0-0036385494