Abstract
A 72-year-old woman was admitted with chest discomfort and general fatigue. She was diagnosed as having cardiac tamponade with massive pericardial effusion. Percutaneous pericardiocentesis yielded bloody effusion. Tuberculous pericarditis was suspected owing to the adenosine deaminase level in this fluid. Video-assisted thoracoscopic pericardial fenestration (VATSPF) was performed for the diagnosis and treatment. Polymerase chain reaction detected Mycobacterium tuberculosis DNA in the pericardial tissues, confirming the diagnosis of tuberculous pericarditis. She received a combination of three-kind medication and anti-tuberculous regimen, and a follow-up check up for more than 2 years, exhibiting a good postoperative course. We conclude that VATSPF can be a useful procedure not only for diagnosis but for release of tuberculous pericarditis with cardiac tamponade and for prophylaxis of constrictive pericarditis.
Similar content being viewed by others
References
Atar S, Chiu J, Forrester JS, Siegel RJ. Bloody pericardial effusion in patients with cardiac tamponade: Is the cause cancerous, tuberculous, or iatrogenic in the 1990s? Chest 1999; 116: 1564–9.
Desai HN. Tuberculous pericarditis: A review of 100 cases. S Afr Med J 1979; 55: 877–80.
Clifford CP, Davies GJ, Scott J, Shaunak S, Sarvill J, Schofield JB. Tuberculous pericarditis with rapid progression to constriction: Prompt diagnosis and treatment are needed. BMJ 1993; 307: 1052–4.
Meyers DG, Meyers RE, Prendergast TW. The usefulness of diagnostic tests on pericardial fluid. Chest 1997; 111: 1213–21.
Martinez-Vazquez JM, Ribera E, Ocana I, Segura RM, Serrat R, Sagrista J. Adenosine deaminase activity in tuberculous pericarditis. Thorax 1986; 41: 888–9.
Godfrey-Faussett P, Wilkins EG, Khoo S, Stoker N. Tuberculous pericarditis confirmed by DNA amplification. Lancet 1991; 337: 176–7.
Cegielski JP, Devlin BH, Morris AJ, Kitinya JN, Pulipaka UP, Lema LE, et al. Comparison of PCR, culture, and histopathology for diagnosis of tuberculous pericarditis. J Clin Microbiol 1997; 35: 3254–7.
Koh KK, Kim EJ, Cho CH, Choi MJ, Cho SK, Kim SS, et al. Adenosine deaminase and carcinoembryonic antigen in pericardial effusion diagnosis, especially in suspected tuberculous pericarditis. Circulation 1994; 89: 2728–35.
Liu HP, Chang CH, Lin PJ, Hsieh HC, Chang JP, Hsieh MJ. Thoracoscopic management of effusive pericardial disease: Indications and technique. Ann Thorac Surg 1994; 58: 1695–7.
Trautner BW, Darouiche RO. Tuberculous pericarditis: Optimal diagnosis and management. Clin Infect Dis 2001; 33: 954–61.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kameyama, K., Huang, Cl., Okamoto, T. et al. Video-assisted thoracoscopic pericardial fenestration for tuberculous pericardial effusion. Jpn J Thorac Caridovasc Surg 52, 68–70 (2004). https://doi.org/10.1007/s11748-004-0086-z
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s11748-004-0086-z