A pericardial window is a cardiac surgical procedure that creates an opening in the pericardium, the membrane sac that encloses the heart. The opening provided can relieve the pressure from fluid that has collected around the heart, called pericardial effusion. It is also possible for the surgeon to view possible biopsy sites through the pericardial window.
Before the window is created, the patient will be put under anesthesia. The usual placement of the window is below the sternum or through the ribs on the left side of the body. The surgeon will make a small incision into the pericardium, allowing the excess fluid to be released into the abdomen. The fluid is later absorbed into the abdominal tissue harmlessly.
Most people who have a pericardial window procedure are able to return home within two days. The operation is usually successful at safely relieving the pressure from the fluid built up around the heart. Most patients report an improvement in their symptoms without a need for further surgery.
Pericardial effusion causes shortness of breath and painful breathing. Some people report a persistent cough and an inability to breathe comfortably lying down. Fainting, dizziness, and a rapid heartbeat are common among people with pericardial effusion. Untreated, this condition can lead to heart failure and death.
The pericardial cavity can fill with fluid for a variety of reasons. Some viral infections can cause a fluid buildup around the heart. People with cancer have been reported to have pericardial effusion during the treatment process. Heart failure can cause fluid to collect in the pericardial sac, and it is not uncommon to have fluid around the heart after cardiac surgery. Renal failure can cause edema in the tissues of the body, including the space around the heart.
Other causes that can precipitate a need for a pericardial window are many. Autoimmune diseases, such as lupus can cause fluid to collect in the pericardium. Some bacterial and fungal infections cause inflammation of the pericardium, which triggers the fluid buildup around the heart. Hypothyroidism and the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) may cause the symptoms of pericardial effusion as well. A traumatic injury to the chest or heart can also cause the condition to develop.
Some medications can cause the pericardial effusion that prompts the surgical formation of a pericardial window. Hydralazine, phenytoin, and isoniazid are some of the medicines that can cause fluid buildup around the heart. Chemotherapy drugs may have pericardial effusion as a side effect of treatment as well.