Therapeutic Strategies and Clinical Outcomes in Cardiac Tamponade: Pericardiocentesis versus Surgical Drainage

Abstract

The thesis reviews the management of cardiac tamponade, comparing pericardiocentesis with surgical drainage techniques, including subxiphoid window, thoracotomy and VATS. It examines procedural success, complications, recurrence of pericardial effusion and mortality using published literature. Pericardiocentesis offers rapid, minimally invasive decompression and has high reported procedural success, making it an important initial intervention. Surgical drainage may provide more durable fluid control and lower recurrence, particularly in recurrent effusions or when pericardiocentesis fails. However, no consistent mortality advantage has been established for either approach, as outcomes are strongly influenced by the underlying cause and patient severity. The thesis concludes that treatment should be individualized, with further prospective, multicentre research needed to strengthen the evidence.