par Lynn Shapiro
, Writer | September 29, 2009
Pericardial effusion, the collection of fluid around the heart, typically occurs in patients following heart surgery and when symptomatic, is usually treated by surgeons, using an invasive surgical drainage technique.
Recently, researchers have discovered that a minimally invasive procedure called CT-guided tube pericardiostomy is just as effective and requires no recovery time. What's more, the procedure costs 89 percent less than the standard surgical drainage technique, according to a study published in the October issue of the American Journal of Roentgenology (AJR).
The study performed by Suzanne L. Palmer, M.D. at the University of Southern California Keck School of Medicine, included 39 CT-guided tube pericardiostomy procedures, all performed successfully.
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"The purpose of this paper was to show the simplicity of using a technique familiar to most radiologists for a [cardiac) procedure that is daunting to those same radiologists," Dr. Palmer tells DOTmed News.
Regarding the cost-savings of the radiological approach, Dr. Palmer says the charges are much lower for some very simple reasons: The CT procedure is done in the imaging department in the CT scanner room with minimum personnel, she says. Typically, only a radiologist and the CT tech are present. The procedure lasts about 30 minutes from start to finish and there is no pre-op or post-op recovery needed.
In comparison, surgical drainage requires the use of an operating suite and general anesthesia. The personnel that are required include a surgeon, anesthesiologist, scrub nurse and OR nurse at minimum. Although, the drainage procedure is very quick, at least one hour of OR time is used. And then the patient needs to be sent to the post-op recovery room, which results in additional charges, Dr. Palmer says.
Cardiac Surgeons May Balk
She notes that because the CT procedure is safe, effective and less costly than surgical drainage, it is a "small but key measure of health care reform." However, she fears cardiac surgeons may balk at letting radiologists take over what is now their work, as it would hurt their pocketbooks.
She tells DOTmed, "I had no problem getting this procedure accepted by my cardiothoracic colleagues at USC because we have an excellent working relationship and we want to do what is best for the patient, regardless of potential loss of income. But I can see how this may be different at other institutions."
Refresher Course at RSNA
Dr. Palmer says her study is an attempt to promote the CT-pericardial procedure. To this end, she has been moderating a refresher course on