Emergency subxiphoid pericardial decompression for XXXX .

@entity1 @entity0 @entity2293 @entity1697 @entity2294 @entity2
@entity2294 can result in acute @entity2293 with serious hemodynamic compromise. This condition requires prompt pericardial decompression for relief of symptoms; however, the risks of general anesthesia in this setting are considerable. In a series of 12 @entity1 , all operated on under local anesthesia without operative mortality, there were six @entity1 with @entity2 ; four @entity1 , secondary to @entity0 ; one @entity1 , secondary to squamous cell @entity1697 ; and one @entity1 , secondary to an unknown primary. The clinical presentation of each was abrupt and echocardiography was definitive. The procedure is performed through an upper abdominal midline incision. The xiphoid process is excised, the diaphragm is visualized, and a pericardial window is created through which two chest tubes are placed through separate stab incisions. The tubes are removed when the drainage has subsided, usually 3-7 days. No medication or irritant is instilled. There was no recurrence following this treatment. The average survival time was 27 weeks with a range of 2-153 weeks. This operation should be part of the repertoire of the general surgeon who treats @entity0 and of the thoracic surgeon who treats @entity2 .
