We present a new approach utilising VATS and a Port-system (Medi-Port MP-GS9; IAP-HMP) that allows home management of pericardial effusion in patients with advanced malignancy and recurrent effusion. All patients underwent thoracoscopic pericardial window under general anaesthesia. On completion of this procedure a Port-system was permanently implanted with the reservoir body placed in a subcutaneous pocket and the outlet catheter inserted into the pleural cavity which allows aspiration of the effusion at home, on becoming symptomatic.