An infusion port for recurrent massive pericardial effusion: a case report.

Background: Patients with recurrent massive pericardial effusion are at risk of recurrent cardiac tamponade. The current standard of care includes repeat pericardiocentesis or pericardial window when recurrent effusions cause haemodynamic compromise. Here, we report a case of a patient in whom an infusion port was used for drainage of recurrent pericardial effusion. Patient was followed up for 10 months demonstrating convenience and safety of use without evidence of cardiac tamponade. Case summary: We present a patient with recurrent massive pericardial effusion after previously undergoing two difficult pericardiocenteses of posteriorly located pericardial effusion causing tamponade. An infusion port was implanted and periodical follow-up and drainage through the port were performed. During follow-up, there was no evidence of tamponade caused by recurrence of pericardial effusion and no complications from the port. Discussion: Pericardiocentesis can be challenging in certain circumstances such as loculated or posteriorly located pericardial effusion. For patients with recurrent effusion, there is an incremental risk of serious complications with every pericardiocentesis. This case illustrates the feasibility of using an infusion port in recurrent pericardial effusion. After subcutaneous implantation of the infusion port, repeat pericardiocentesis and its related complications were avoided. Later pericardial decompression and intrapericardial administration of medications were simple and safe by accessing the port top.