Window Procedure

A pericardial window is a procedure done on the sac around the heart. Everyone has a fibrous sac, called the pericardium, that surrounds the heart. The sac has two thin layers with a small amount of fluid between them. When the heart beats, the fluid between the two layers helps to reduce friction.

When too much fluid builds up, the heart has trouble functioning properly. This is when a pericardial window procedure may be necessary.  Surgically removing a small part of the sac lets doctors drain excess fluid from the sac.

Conditions that might need a pericardial window include:

• Infection of the heart or pericardial sac
• Cancer
• Injury
• Inflammation of the pericardial sac due to a heart attack
• Immune system disease
• Reactions to certain drugs
• Previous cardiac surgery

Other times, the cause of the fluid buildup is unknown.

BEFORE THE PROCEDURE

To get ready for a pericardial window, you should not eat or drink anything after midnight the night before the procedure. Your doctor may order some extra tests before the surgery such as chest x-rays, electrocardiogram (to check the heart rhythm), blood tests, echocardiogram (to view heart anatomy and blood flow through the heart), CT or MRI, or heart catheterization.

DURING THE PROCEDURE

Your doctor will discuss with you what you can expect during the surgery. An anesthesiologist will likely give you general anesthesia before the surgery starts so that you sleep during the operation. You may have a breathing tube to help you during the surgery. In a few cases, anesthesia is not used and you are given medication to relax. The surgery will take several hours. In some cases, a cut (incision) will be made below the breastbone. In other cases, several small incisions on the left side are made to reach the heart.
Whatever method your surgeon chooses to use, the muscle and the skin incisions will be closed and a bandage applied.

AFTER THE PROCEDURE

After the surgery, you will need to stay in the hospital for at least a few days. This will partially depend on the reason you needed a pericardial window. You may feel some soreness for the first few days, but you shouldn’t feel severe pain.

You should be able to resume normal activities relatively soon, but you may be a little more tired for a while after surgery.