Pericardial drainage and pericardial fenestration

What is pericardial drainage?

The pericardium is a sturdy fibrous sac surrounding the heart in which a little bit of fluid can be found. Abnormal fluid buildup can be drained using a thin tube (also known as a drain) through the skin (percutaneous). During pericardial drainage, the fluid buildup in the sac is removed through a drain. This is an image-guided procedure (ultrasound) led by your interventional radiologist. Percutaneous drainage is often the safest, most minimally invasive and more effective way to remove fluid buildup from the body.

What is a pericardial fenestration?

During a fenestration, we create an opening in the sac surrounding the heart to drain the fluids. This procedure is an option for people who do not benefit (enough) from pericardial drainage alone.

What to expect?

During pericardial drainage or fenestration, you will stay at the hospital. You can eat and drink normally before the procedure. We will administer an IV and connect an ECG. The procedure will take place at the radiology department. You will be lying down on your back with an x-ray tube. This table is designed for use with image-guided procedures. This table is designed for image-guided procedures. You will receive a local anesthetic after which your interventional radiologist will make a small incision in the skin. The fluids in your pericardium will be punctured using an ultrasound, and a small wire will be placed in the sac. A tube will be placed over the wire to drain the fluids. We can place balloons on this wire to create an opening in the pericardium (pericardial fenestration). 

After your treatment, your cardiologist or intensivist will see you for a checkup, to see whether enough fluids have been drained and to determine when the drain can be removed.

What are the potential complications and side effects?

The most common complications are skin infection around the drain and bruising. Rare but more unpleasant complications include bleeding or pressure ulcers in the area of the drain. In rare cases, an organ may be damaged during the puncture, resulting in pneumothorax, pulmonary embolism, or cardiac arrhythmia.