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September 22, 1978

Treatment of Intractable Uremic Pericardial Effusion: Avoidance of Pericardiectomy With Local Steroid Instillation

Author Affiliations

From the Division of Nephrology, the Departments of Medicine (Drs Buselmeier, Davin, and Kjellstrand), Surgery (Drs Buselmeier, Simmons, Najarian, and Kjellstrand), and Microbiology (Dr Simmons), University of Minnesota Hospitals, Minneapolis.

JAMA. 1978;240(13):1358-1359. doi:10.1001/jama.1978.03290130052019

Forty-five patients with uremic pericardial effusion were treated with local instillation of nonabsorbable steroid through an indwelling pericardial drainage catheter and followed up from one to 54 months. In these patients previous intensive dialysis and other attempts at control of the effusions were unsuccessful. The average hospitalization for percutaneous therapy was eight days. An asymptomatic internal mammary artery fistula developed in one patient. Another had resolution of her pericardial effusion but not of associated pericardial pain. She subsequently underwent pericardiectomy (stripping), without resolution of her pain. One patient had a recurrence of her effusion six months after therapy. Complications of this technique are rare. The relatively noninvasive drainage and local instillation of a nonabsorbable steroid is almost universally effective.

(JAMA 240:1358-1359, 1978)