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Titolo:
Echocardiographically guided and contrast agent controlled pericardiocentesis
Autore:
Caspari, G; Bartel, T; Mohlenkamp, S; Bersch, B; von Birgelen, C; Krapp, J; Erbel, R;
Indirizzi:
Univ Essen Gesamthsch, Zentrum Innere Med, Abt Kardiol, D-45122 Essen, Germany Univ Essen Gesamthsch Essen Germany D-45122 diol, D-45122 Essen, Germany
Titolo Testata:
HERZ
fascicolo: 8, volume: 25, anno: 2000,
pagine: 755 - 760
SICI:
0340-9937(200012)25:8<755:EGACAC>2.0.ZU;2-D
Fonte:
ISI
Lingua:
GER
Soggetto:
PERCUTANEOUS BALLOON PERICARDIOTOMY; CARDIAC-TAMPONADE; EFFUSION; MANAGEMENT; EXPERIENCE; DISEASE;
Keywords:
echocardiographically guided pericardiocentesis cardiac tamponade; recurrent pericardial effusion; risk of pericardiocentesis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Caspari, G Univ Essen Gesamthsch, Zentrum Innere Med, Abt Kardiol, Hufelandstr 55, D-45122 Essen, Germany Univ Essen Gesamthsch Hufelandstr 55 EssenGermany D-45122 any
Citazione:
G. Caspari et al., "Echocardiographically guided and contrast agent controlled pericardiocentesis", HERZ, 25(8), 2000, pp. 755-760

Abstract

The most effective treatment for pericardial effusion and cardiac tamponade is removal of the pericardial fluid. Surgical pericardiotomy is associated with high mortality and morbidity. Similarly, subcostal percutaneous blind pericardiocentesis was reported to have unacceptably high mortality and complication rates. Major complications associated with blind needle punctures are right heart penetration, hemopericardium, puncture of the coronary arteries, liver and lung bleeding. Even under fluoroscopic guidance and electrocardiographic needle monitoring high complication rates persist. Pericardial drainage has been often inadequate, with frequent recurrences of significant pericardial effusions. Two-dimensional echocardiographically guided pericardiocentesis is reported to improve efficacy and safety of percutaneous puncture. Moreover, it allows immediate verification of the procedural success. We evaluated the efficacy and safety of an echocardiographically guided contrast agent controlled pericardiocentesis. This is a retrospective, descriptive study on 126 consecutive patients whounderwent percutaneous pericardiocentesis at the University Hospital Essen, Germany, from 1995 to June 2000. There were 51 women (41%) and 75 men (55%) with a mean age of 52 +/- 14 years. Standard techniques for quantification of pericardial effusion were used. Depending on the localization of the pericardial effusion an apical or subxiphoidal approach was chosen. The puncture was performed under echocardiographic guidance and the position of the needle was controlled by injection of contrast agent. Over a long guidewire a pigtail catheter was inserted through a sheath for further drainage ofpericardial fluid. The catheter was removed after a maximum of 48 hours toavoid infection of the pericardial cavity. An apical approach was chosen in 98 patients (78%), a subcostal in 28 patients (22%). The procedure was successful in 99% of the attempts. No death or clinical complication occurred. The maximal pericardial diameter measuredby two-dimensional echocardiography was 32 +/- 16 mm before and 5,3 +/-2 mm after drainage. The calculated pericardial effusion was 657 +/- 342 ml. Afluid volume of 605 +/- 342 ml could be drained. In all patients a pericardial catheter was placed for 1.4 +/- 0.8 days. Recurrence of pericardial effusion occurred in 18 patients (14%). Of these, 15 patients underwent repeated successful pericardiocentesis (2.5 +/- 0.8), and 3 patients were referred to surgical pericardiotomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 18:46:31