Percutaneous Balloon Pericardiotomy: A Safe and Effective Approach for Managing Recurrent Massive Pericardial Effusion

Percutaneous balloon pericardiotomy (PBP) has emerged as a less invasive alternative to surgical interventions for recurrent severe pericardial effusion (PE), particularly in patients with malignancies. This study evaluates the safety and efficacy of PBP in patients with recurrent severe PE. A total of 42 patients with recurrent severe PE underwent PBP between March 2008 and July 2024. PBP was performed under conscious sedation with fluoroscopic guidance using a 20-mm by 60-mm balloon. Data were collected on patient demographics, echocardiographic findings, procedural details, and follow-up outcomes. The study population had a mean age of 58.4 ± 11.2 years, with 54.8% being female. Most patients (76.2%) had malignant PEs. The procedure was technically successful in all cases, with no immediate complications. The median hospital stay was 4 days. Post-procedural transthoracic echocardiography showed no residual effusion in 40.5% of patients and minimal effusion in 50%. Over a median follow-up of 353 days, 54.8% of patients died due to the progression of underlying malignancies, and four patients experienced recurrent effusions requiring additional intervention. PBP is a safe and effective treatment for recurrent severe PE, particularly in patients with malignancies. The procedure's high success rate and favorable safety profile suggest it might be considered a first-line treatment option in appropriate clinical settings.