       Document 0115
 DOCN  M9590115
 TI    The role of the 'pericardial window' in AIDS.
 DT    9509
 AU    Flum DR; McGinn JT Jr; Tyras DH; Department of Surgery, St. Vincent's
       Hospital and Medical Center,; New York, NY 10011, USA.
 SO    Chest. 1995 Jun;107(6):1522-5. Unique Identifier : AIDSLINE MED/95300502
 AB    BACKGROUND: The leading cause of pericardial effusion in urban hospitals
       is now AIDS-related pathologies. Clinically, these effusions are a
       diagnostic and management dilemma. In our institution, pericardial
       biopsy and operative drainage have become part of the diagnostic and
       management plan. Surgical intervention, however, has appeared to have
       little clinical impact. METHODS: A retrospective review was conducted of
       all patients (n = 29) diagnosed as having AIDS who underwent pericardial
       window for pericardial effusions from 1986 to 1994. RESULTS: Fluid
       cultures and pericardial biopsy were performed in all cases. Twenty-four
       percent of culture or biopsy specimens were diagnostic (7 of 29 = 2
       adenocarcinoma, 3 lymphoma, 1 Staphylococcus aureus, 1 Mycobacterium
       tuberculosis). In 94% of cases, there was no change in clinical
       management based on operative results. In 4 of 7 cases, the patients
       were ineligible for the indicated therapy based on underlying illness
       and in 1 of 7, the patient was receiving appropriate therapy for
       previously diagnosed disease. Ventilatory complications were noted in
       17%. Three patients did not wean from the ventilator and died shortly
       after the operation. Sixty-nine percent mortality was noted at 8 weeks
       post-operatively. One hundred percent mortality was noted at 22 weeks
       with 86% follow-up. CONCLUSION: AIDS-related pericardial effusion is
       associated with a grave prognosis. Operations for diagnostic benefit
       provide little practical information and are not justified.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS
       Adenocarcinoma/COMPLICATIONS  Adult  AIDS-Related Opportunistic
       Infections/COMPLICATIONS  Human  Lymphoma, AIDS-Related/COMPLICATIONS
       Male  Pericardial Effusion/COMPLICATIONS/DIAGNOSIS/*SURGERY/THERAPY
       *Pericardial Window Techniques  Retrospective Studies  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

