Document Detail

Echocardiography-guided pericardiocentesis with the apical approach
MedLine Citation:
PMID:  19553741     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We aimed to evaluate our experience with echocardiography-guided pericardiocentesis with the apical approach for pericardial effusions. STUDY DESIGN: We evaluated 32 pericardiocenteses performed under echocardiography guidance and with the apical approach in 29 patients (15 men, 14 women; mean age 49 years; range 18 to 72 years). Indications were diagnostic purpose, pericardial tamponade, or symptomatic pericardial effusion. Procedural success, the amount of drainage, and complications were assessed. RESULTS: Common causes of pericardial effusion were malignancy (n=6), postpericardiotomy syndrome (n=5), idiopathic (n=5), chronic renal disease (n=4), and myocardial infarction (n=3). The amount of drainage was 120 ml to 2,200 ml and the duration of pericardial catheter placement in the pericardial space was 24 to 144 hours. Mortality did not occur. Echocardiographic control showed residual effusion in the lateral wall in one case, which required repositioning of the pericardial catheter for complete removal. The procedure failed in one patient due to insufficient drainage caused by multiple septations and fibrinous fluid in the pericardial space. The success rate of the procedures was 96.9%. Four cases developed hemopneumothorax requiring tube drainage, vasovagal reaction, nonsustained ventricular tachycardia, and frequent ventricular extrasystoles, respectively. Apical puncture was repeated in two cases due to erroneous left ventricular puncture and pleural catheter placement, respectively. CONCLUSION: Echocardiography-guided pericardiocentesis with the apical approach is readily performed bedside without the need for catheterization laboratory, with a high success rate and low complication rate. It should be considered especially in cases in which anterior pericardial collection is more prominent where it will reduce unnecessary surgical interventions.
Hasan Orhan Ozer; Vedat Davuto?lu; Musa Cakici; Adnan Do?an; Ibrahim Sari; Mustafa Oylumlu; Mehmet Aksoy
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  T?rk Kardiyoloji Derne?i ar?ivi : T?rk Kardiyoloji Derne?inin yay?n organ?d?r     Volume:  37     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-06-25     Completed Date:  2010-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  tur     Pagination:  177-81     Citation Subset:  IM    
Department of Cardiology, Medicine Faculty of Gaziantep University, Gaziantep, Turkey.
Vernacular Title:
Ekokardiyografi rehberli?inde apikal yakla?imla perikardiyosentez.
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MeSH Terms
Cardiac Tamponade / surgery,  ultrasonography
Drainage / adverse effects,  methods
Echocardiography / methods*
Heart Catheterization / methods
Middle Aged
Pericardiocentesis / methods*
Postpericardiotomy Syndrome / surgery,  ultrasonography
Treatment Outcome

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