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Arquivos Brasileiros de CardiologiaResumo das Próximas PublicaçõesAno 2001
Video-Assisted Pericardioscopy. How to Improve Diagnostic Efficacy in Pericardial Effusions
Paulo M. Pêgo-Fernandes, Fabio Fernandes, Barbara M. Ianni, Sandra Serson Rohr, Isabela Miranda Bernardelli, Fabio B. Jatene, Sérgio A. Oliveira
Objective – To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period.
Methods – From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type.
Results – The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45%) patients, neoplastic in 4 (20%), resulting from hypothyroidism in 3 (15%), tuberculous in 2 (10%), due to cholesterol in 1 (5%), and chylopericardial in 1 (5%). The biopsy was positive in 30% of the patients, and the etiology could not be defined in 45% of the patients.
Conclusion – Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic.
Key words: video-assisted thoracoscopy, biopsy, etiology
Instituto do Coração do Hospital das Clínicas - FMUSP Mailing address: Paulo M. Pêgo-Fernandes
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