The BALTO Registry: Long-term results of percutaneous BALloon pericardioTomy in oncological patients

• Published in: Catheterization and cardiovascular interventions Vol. 103; no. 3; pp. 482 - 489
• Main Authors: Rivero-Santana, Borja, Jimenez-Valero, Santiago, Jurado-Roman, Alfonso, Galeote, Guillermo, Lopez-Fernandez, Teresa, Moreno, Raul
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-02-2024
• Subjects: Aged; Balloon Occlusion - adverse effects; Balloon treatment; Female; Humans; Male; Middle Aged; Patients; Pericardial Effusion - diagnostic imaging; Pericardial Effusion - etiology; Pericardial Effusion - therapy; Pericardiectomy - adverse effects; Pleural effusion; Prospective Studies; Treatment Outcome; recurrent effusion; malignant pericardial effusion; cardiac tamponade; balloon pericardiotomy; oncological patients
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.30953

The aim of this study was to analyze the efficacy and safety of percutaneous balloon pericardiotomy (PBP) in oncological patients who present with a malignant pericardial effusion (MPE).
The use of PBP as a treatment for MPE is not standardized due to the limited evidence. Furthermore, the performance of a second PBP for a recurrence after a first procedure is controversial.
The BALTO Registry (BALloon pericardioTomy in Oncological patients) is a prospective, single-center, observational registry that includes consecutive PBP performed for MPE from October 2007 to February 2022. Clinical and procedural, characteristics, as well as clinical outcome were analyzed.
Seventy-six PBP were performed in 61 patients (65% female). Mean age was of 66.4 ± 11.2 years. In 15 cases, a second PBP procedure was performed due to recurrence despite the first PBP. The procedure could be performed effectively in all cases with only two serious complications. Ninety-five percent of cases were discharged alive from the hospital. During a median follow-up of 6.3 months (interquartile range [IQR], 0.9-10.8), MPE recurred in 24.5% cases although no recurrences were reported after the second procedure. No evidence of malignant pleural effusion developed on follow-up. The median overall survival time was 5.8 months (IQR, 0.8-10.2) and the time to recurrence after the first PBP was 2.4 months (IQR, 0.7-4.5).
PBP is a safe and effective treatment for MPE. It could be considered an acceptable therapy in most MPE, even in those who recur after a first procedure.