Which procedure is used for recurrent pericardial effusion?

• A. Pericardiocentesis
• B. Pericardial window drainage
• C. Thoracentesis
• D. Pleurodesis

Answer: (B)

For recurrent pericardial effusion, the goal is a durable drainage route that prevents the fluid from piling up again around the heart. A pericardial window creates a permanent opening from the pericardial space to the pleural (or sometimes peritoneal) cavity, allowing continuous drainage. This reduces the need for repeated taps and provides longer-lasting control of the effusion, which is especially important when the underlying cause is ongoing or when fluid keeps reaccumulating despite initial drainage.

Pericardiocentesis is great for quick, temporary relief of fluid around the heart but often doesn’t stop recurrence because it doesn’t address the underlying tendency to accumulate fluid. Thoracentesis removes pleural fluid, not pericardial fluid, so it doesn’t treat the problem around the heart. Pleurodesis targets the pleural space to prevent pleural effusions and isn’t used to manage fluid around the heart.