Open versus thoracoscopic pericardectomy: What is the evidence?

Objective
To evaluate the disease-free interval (DFI) and median survival time (MST) in dogs with idiopathic and neoplastic pericardial effusion surgically treated by thoracoscopic creation of a pericardial window or subtotal pericardectomy via thoracotomy and to compare DFI and MST in dogs with and without a mass on preoperative echocardiography that underwent either surgical technique.

Design
Retrospective cohort study.

Animals
58 dogs with pericardial effusion.

Procedures
Medical records between 1985 and 2010 were evaluated. Dogs were included in the study if they had confirmed pericardial effusion and underwent thoracoscopic creation of a pericardial window (ie, pericardial window technique) or subtotal pericardectomy via thoracotomy.

Results
Clinical signs of dogs at initial evaluation were similar, with the exception of lethargy, between dogs treated by subtotal pericardectomy via thoracotomy or the pericardial window technique. Dogs with idiopathic pericardial effusion that underwent the pericardial window technique had a significantly shorter DFI and MST than did those treated by subtotal pericardectomy via thoracotomy. For neoplastic pericardial effusion, DFI and MST were not significantly different between dogs treated with either surgical technique.

Conclusions and Clinical Relevance
Dogs with idiopathic pericardial effusion treated with a subtotal pericardectomy via thoracotomy had a significantly longer DFI and MST, compared with dogs treated by the pericardial window technique. This difference in outcome may be related to the inaccuracy of the initial diagnosis or ineffectiveness of the pericardial window to palliate the signs of idiopathic pericardial effusion long term.