Parasternal toracotomy: a new mini-invasive approach to the pericardium

Frizzi, M. ; D’Ettorre, P. ; Bertolini, G. ; Angeloni, L.
Author Affiliation: Dipartimento di chirurgia, Clinica Veterinaria San Marco, Padova, Italy.
Parasternal toracotomy: a new mini-invasive approach to the pericardium
[Foreign Title] Toracotomia parasternale: una nuova via d’accesso mini-invasiva al pericardio
Journal article: Veterinaria (Cremona) 2018 – Vol.32 No.1 pp.55-62 ref.21
Author Email: massimodoc@gmail.com

Abstract
Pericardiectomy is the favourite surgical technique for the treatment of pericardial effusions with cardiac tamponade. Surgery is indicated in all cases of recurrent effusion after resolution of acute presentation by pericardiocentesis. In literature the most used technique is subtotal pericardiectomy. More recently minimally invasive techniques allowed to reduction of morbidity compared to traditional surgery. The purpose of this paper is to describe a new mini-invasive technique for pericardiectomy and to document the results of a six cases series. Six dogs underwent a complete blood tests and urine analysis, ultrasounds examination, pericardiocentesis and C.T. scan. Pericardiectomy was performed in all cases with a left eleventh intercostal thoracotomy approach in a parasternal position. All the pericardial resected portions were measured and histologically examined. Four dogs had a neoplastic lesion of the heart base and no recurrence of the pericardial effusion. Two dogs had an inflammatory disease (pericarditis) and showed a clinically relevant pleural effusion after surgery, that required further treatments. All dogs were discharged 24 hours after surgery. Parasternal pericardiectomy may be a good option for the minimally invasive treatment of recurrent pericardial effusions, particularly in case of neoplastic lesions of the heart base. It’s similar regarding the morbidity but potentially faster and easier to perform. It doesn’t need dedicated equipment.