Journal of Cardiology and Heart Failure

ABSTRACT

Background

Pericardial window procedures are commonly performed for the management of recurrent or symptomatic pericardial effusion. Comparative data between pericardioperitoneal window (PPW) and pleuropericardial window (PLW) procedures remain limited. This study aimed to compare perioperative outcomes and complications between both techniques.

Methods

A retrospective exploratory cohort study was conducted including patients who underwent surgical pericardial window creation at Jordan University Hospital between 2000 and 2025. Patients were divided into PPW and PLW groups. Baseline characteristics, perioperative variables, postoperative complications, and length-of-stay outcomes were analyzed descriptively and comparatively. Continuous variables were reported as median [IQR], and categorical variables as n/N (%). Fisher’s exact and Wilcoxon rank-sum tests were used where appropriate. Effect estimates were reported with 95% confidence intervals.

Results

The study cohort included 12 patients, of whom 5 underwent PPW and 7 underwent PLW. Median age was 55 [38–65] years in the PPW group and 52 [29–55] years in the PLW group. Early 30-day complications occurred in 3/5 (60.0%) PPW patients and 5/7 (71.4%) PLW patients (RR 1.19, 95% CI 0.51–2.80; p=1.000). PLW was numerically associated with shorter hospital length of stay (9 vs 13 days), shorter ICU stay (1 vs 2 days), lower estimated blood loss (50 vs 150 mL), and shorter chest tube duration (1 vs 4 days), although none reached statistical significance. Mortality data were available for only 6 patients, and follow-up duration was documented in only 1 patient, limiting assessment of long-term outcomes.

Conclusions

Both PPW and PLW procedures demonstrated substantial early complication rates without statistically conclusive differences between groups. Although PLW showed numerically favorable perioperative outcomes, findings were limited by the small sample size, temporal heterogeneity, and incomplete follow-up. Larger prospective multicenter studies are needed to better define comparative effectiveness and long-term durability.

Keywords: Preventive Cardiology; Cardiovascular Disease; Risk Assessment; Digital Health; Lifestyle Intervention; Public Health