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Pericardiectomy is the treatment for recurrent tamponade and/or constrictive pericarditis and in occasional cases of chronic pericardial pain without effusion or constriction. For cardiac tamponade and constrictive pericarditis removal of the pericardium should be as complete as possible. Biopsy and drainage can sometimes be accomplished by using a thoracoscope with a smaller resulting incision. In some cases, a surgical subxiphoid pericardial window may be created to allow drainage of pericardial fluid into the pleural space externally through a chest tube. The surgery is minimal, but frequently the window reseals and recurrent pericardial effusion occurs.