The pericardium is the sac that surrounds the heart. A pericardectomy is removal of the pericardium. This is usually performed because of pericardial effusion (fluid around the heart) or pericardial constriction. Pericardial effusion can either be idiopathic (no known cause) or due to a tumor that is bleeding. The effusion (fluid) around the heart does not allow the heart to function properly and causes right sided heart failure to develop. Clinical signs that an animal may exhibit with pericardial effusion are exercise intolerance, ascites (fluid in the abdomen), peripheral edema, and pleural effusion (fluid within the chest cavity). These patients can also be presented for acute collapse.

 

A radiograph of the chest and an ultrasound of the heart will be needed to confirm the diagnosis of pericardial effusion. A thoracocentesis will be performed to remove the fluid in the pericardium which will provide immediate relief to the patient. A sample of the fluid taken will be analyzed for a possible cause of the accumulation of the fluid. Patient may not have a return of clinical signs for days or weeks after the pericardocentesis. The patient is considered for surgery when the effusion rapidly returns, needs multiple pericardiocentesis in a short amount of time, or if constrictive pericardial disease is present.

A subtotal pericardectomy is the surgery treatment of choice. This procedure requires a thoracotomy. Dogs with idiopathic pericardial effusion or constrictive pericardial disease are often cured with a pericardectomy. In dogs with pericardial effusion due to cancer (tumor on the heart), a pericardectomy is performed to avoid complications associated with the effusion. This does not treat the underlying cancer, but provides a better quality of life for these patients. This procedure requires meticulous attention to anatomy and surgical technique and is best performed by a Board Certified Surgeon.