This journal only 2001, Number 1 Rev Mex Cir Endoscop 2001; 2 (1) Anterior pericardiectomy by thoracoscopy in a second level hospital Vega CGR, Lafragua CMCV, Arellano RV, Preciado BCY, Piña CJ, Cervantes CJ Full text How to cite this article Language: Spanish References: 12 Page: 31-35 PDF size: 302.62 Kb. Key words: Thoracoscopy, pericarditis, tamponade. ABSTRACT Objective. Describe one case of a patient who developed a cardiac tamponade, that was solved by an anterior pericardiectomy using thoracoscopic approach. Design. Report of one case. Place. General Hospital (second level). Description of the case. The treatment of a 20 years old male with the following antecedents related to his pathology: three years of evolution of nephrotic syndrome, developing an uremic pericarditis secondary to a chronic renal failure, besides a one year evolution of a hypertensive cardiopathy; the patient was also in a program of ambulatory peritoneal dialysis. The patient was admitted to the hospital presenting vomitus, respiratory failure, pericardiac friction and jugular enlargement. The next laboratory tests were included: PA thoracic radiography presenting grade IV cardiomegaly, echocardiogram reporting constrictive trabecular pericardial effusion; General Surgery consultation was requested for pericardiac window and/or pericardiectomy by sternotomy, minimal access thoracic surgery approach was suggested, performing anterior pericardiectomy by thoracoscopic access, draining 1400 c.c of intrapericardiac hemorrhagic fluid and placing a pleurostomy probe in left hemithorax, eliminating cardiac symptomatology and removing the water seal at the sixth day of the postoperative. The patient egresses asymptomatic of the cardiac problem and with improvement of his azoic levels. The histopatologic inform reported a possible nodose polyarteritis and fibrin conglomerate. Conclusion. Thoracoscopic approach is a good and new surgical option to perform an anterior pericardiectomy in patients with constrictive uremic pericarditis. REFERENCES Colombo A, Olson HG, Egan J, Gardin JM. Etiology and prognostic implications of a large pericardial effusion in men. Clin Cardiol 1988; 11: 389. Guadalajara JF. Pericarditis. En: Cardiología. 3a. Ed. Mexico D. F.: Ediciones Francisco Méndez Oteo, 1985: 627. Rostand SG, Rutsky EA. Pericarditis in end-stage renal disease. Cardiol Clin 1990; 8: 701. Rutsky EA. Treatment of uremic pericarditis and pericardial effusion. Am J Kidney Dis 1987; 10: 2. Lundin AP. Recurrent uremic pericarditis: A marker of inadequate dialysis. Semin Dial 1990; 3: 5. Connors JP, Kleiger RE, Shaw RC et al. The indications for pericardiectomy in the uremic pericardial effusion. Surgery 1976; 80: 689. Caccavale RJ. Video assisted thoracic surgery for pericardial disease. Chest Surg Clinics N Am 1993; 3(2): 271. Camacho DF. Videotoracoscopia. En: Cervantes CJ, Felix PJ. Laparoscopia y toracoscopia. la. Ed. Mexico D.F.: Ediciones Mcgraw-Hill. 1997: 317. Spector D, Alfred H, Siedlecki M, Briefel G. A controlled study of the indomethacin in uremic pericarditis. Kidney Int 1983; 24: 663. Cervantes CJ, Chousleb A, Shuchleib S, Rojas G, Cardenas L, Cañas M. Resección de bulas enfisematosas por toracoscopia. Cir Gen 1994; 16: 275-278. Alvarez TR, Millan M, Tovar L, Shuchleib SA, Alvarez TR, Chousleb A. Thoracoscopic clipping and ligation of a patent ductus arteriosus. Ann Thorac Surg 1994; 57: 755-757. Cueto J, Melgoza C, Weber A. Resección de tumor pulmonar por toracoscopia. Cir Gen 1994; 16: 13-15.