Editing Pericardial window (section)

== Pericardial window: ==

* Preparation
** Preferably monopolar if no PPM, but can be done with bipolar (consider LigaSure)
* Can technically be done under LA
* Consider prep and drape prior to GA
* 5-10cm upper midline incision, starting on xiphoid
* Xiphoid lifted or resected
* Extra-peritoneal dissection bluntly towards pericardium
* Sweep cardiophrenic fat pad away bluntly to identify pearly pericardium
* Identify left phrenic nerve (may not be able to see it)
* Grasp pericardium anterior to phrenic nerve between two Ellis then make a pericardiotomy - 4x4cm window
* Place pleural drainage catheter into pericardial space posteriorly (20Fr chest drain on UWSD, tied in like an ICC, coming out lateral to wound)
* If blood gushes and haemodynamic collapse occurs - need left anterolateral thoracotomy