Pericardial Resection/Window - HFpEF, Pericardial Effusion

Posted by Rob Schweiger @robschweiger, Jul 3, 2019

Mayo has just begun a clinical trial involving percutaneous pericardial resection … in effect, making a longitudinal cut through the chest muscle and pericardium in order to possibly provide relief to a hard, stiff heart muscle. This will occur in the cardio cath lab at the St. Mary’s campus. I’m interested in hearing from anyone who has undergone this or a similar procedure. Also interested in hearing from anyone with HFpEF that has no “usual” symptoms other than inability to exercise and major exhaustion

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

@ninimurphy

Hi Colleen! I checked the link you sent, not much information about procedure, so lots of questions about this trial.
Would love to be added to this group

Jump to this post

Hi @ninimurphy, you're right. The clinical trial link provides only the basic information. As Rob suggests, you can contact the clinical study coordinator for more details about the procedure and what it entails, without being obliged to participate. I encourage you to contact Laura Kveene at 507-422-5241 to ask all your questions. Let us know how it goes (if you want).

REPLY

Will do next week when get back home. Let you know what I learn

REPLY
@ninimurphy

Will do next week when get back home. Let you know what I learn

Jump to this post

Any more information available?

REPLY
@robschweiger

Any more information available?

Jump to this post

Haven’t had chance to call. In middle of relocating elderly parents, so little nuts, between that and trying to stay healthy, as I am sure you can relate to.
I will post when have opportunity to call

REPLY
@ninimurphy

Haven’t had chance to call. In middle of relocating elderly parents, so little nuts, between that and trying to stay healthy, as I am sure you can relate to.
I will post when have opportunity to call

Jump to this post

Wondering if you had an opportunity to get an update yet?

REPLY

Hi @robschweiger @ninimurphy

Here is detailed information about the trial:
Minimally Invasive Pericardiotomy as a New Treatment for Heart Failure https://www.clinicaltrials.gov/ct2/show/NCT03923673

You might also be interested in reading this journal paper to learn more about the procedure:
Percutaneous Pericardial Resection https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.116.003612

REPLY
@kanaazpereira

Hi @robschweiger @ninimurphy

Here is detailed information about the trial:
Minimally Invasive Pericardiotomy as a New Treatment for Heart Failure https://www.clinicaltrials.gov/ct2/show/NCT03923673

You might also be interested in reading this journal paper to learn more about the procedure:
Percutaneous Pericardial Resection https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.116.003612

Jump to this post

I appreciate the effort you made to reference the clinical trial and research paper. However, I already had reviewed both quite a while ago. In fact, I was scheduled to be the first research human being to undergo the procedure but due to scheduling problems in the spring, I was unable to do so. Other developments then led me to not undergo the procedure yet. I am keenly interested in knowing how the first patient did. I believe there will be a second patient this week or next and then a third patient. If Dr. Borlaug is successful with this new clinical trial, it would indeed be a game changer for other patients such as myself with HFpEF. Looking forward to hearing more about this when it is available.

REPLY

I went into my prompt care for a cough I had been having for a few months, and as I have a history of melanoma I asked for a chest xray. That came back irregular, which sent me to get a CT. That showed a large pericardial effusion as well as a tumor. They sent me to ER but heart function was normal aside from the effusion so I was to go home then back for a needle biopsy on the tumor. While doing the needle biopsy my lung got punctured and I ended up going back to the ER, which resulted in an 11 day hospital stay as the ER Dr. did not like how the pericardial effusion looked when seeing it on an echo. I had a chest tube for lungs, another lymph node removed, and a catheter for the pericardial effusion. The catheter was tried unsuccessfully 3 times, but the fluid kept coming back. It tested positive for melanoma, which I had at a stage 1B back in 2013. We finally decided to do the pericardial window. I had the drain in for a little more than 3 weeks. When pulled it had been 75 cc or a little below for a few days, and a few days before that it was at 100 cc. Obviously I am glad to have it out, and none of the Drs seemed worried at all. I am of course worried, every time I cough I think it is coming back. From what I understand, the window is a permanent solution to prevent it from building up again, and if it does come back it should just go directly to waste and not do any harm. Is this correct? Is there a possibility of this coming back and having to have more surgery? My Dr said that they had not seen that happen. I am not able to find a lot online. Thanks for any help!!

REPLY

Hi @katyb879,

Welcome to Connect. I moved your message and combined it with this existing discussion as I thought it would be beneficial for you to be introduced to fellow members who are discussing the pericardial resection/pericardial window procedure.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

I’m tagging @notallwhowanderarelost @gailkattouf @dclo, and I hope they will join in with their insights about this procedure. @sbrooks1986 has also written about the pericardial window surgery in this discussion, https://connect.mayoclinic.org/discussion/hello-i-am-a-29-yr-old-female-who-had-a-pericardial/

With regard to recurrence, here are two (encouraging:) published studies you might wish to go through:
– Outcomes after pericardial window surgery (PWS) for palliation of malignant pericardial effusion (MPE). https://ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.e22193
– Pericardial-peritoneal window for malignant pericardial effusion http://shc.amegroups.com/article/view/4333/5128

@katyb879, I can imagine you wouldn’t want to go through another surgery! Have your doctors offered any other alternatives, if you suspect fluid is building up again?

REPLY
@katyb879

I went into my prompt care for a cough I had been having for a few months, and as I have a history of melanoma I asked for a chest xray. That came back irregular, which sent me to get a CT. That showed a large pericardial effusion as well as a tumor. They sent me to ER but heart function was normal aside from the effusion so I was to go home then back for a needle biopsy on the tumor. While doing the needle biopsy my lung got punctured and I ended up going back to the ER, which resulted in an 11 day hospital stay as the ER Dr. did not like how the pericardial effusion looked when seeing it on an echo. I had a chest tube for lungs, another lymph node removed, and a catheter for the pericardial effusion. The catheter was tried unsuccessfully 3 times, but the fluid kept coming back. It tested positive for melanoma, which I had at a stage 1B back in 2013. We finally decided to do the pericardial window. I had the drain in for a little more than 3 weeks. When pulled it had been 75 cc or a little below for a few days, and a few days before that it was at 100 cc. Obviously I am glad to have it out, and none of the Drs seemed worried at all. I am of course worried, every time I cough I think it is coming back. From what I understand, the window is a permanent solution to prevent it from building up again, and if it does come back it should just go directly to waste and not do any harm. Is this correct? Is there a possibility of this coming back and having to have more surgery? My Dr said that they had not seen that happen. I am not able to find a lot online. Thanks for any help!!

Jump to this post

@katyb879
Hi there,
Sadly, things don’t always go as planned.
My cousin also had pericardial effusion. He had two pericardiocentesis procedures which removed a lot of fluid. The fluid quickly
re-accumulated so he had a pericardial window. This too failed to control the large amount of fluid so a second window was done, this time a subxiphoid window. It too was unsuccessful so they had to remove as much of his pericardium as possible. This was successful however during one of the surgeries a nerve was damaged or cut, probably the phrenic nerve that controls the diaphragm. Now some of his abdominal organs are in his chest and because the diaphragm is partially paralyzed he’s on oxygen 24/7. The cause of the fluid has never been determined.
Good luck,
Jake

REPLY
Please sign in or register to post a reply.