Anatomy of the Pericardium Relevant for Pericardial Access, Pericardioscopy, and Intrapericardial Interventions

Maisch, Bernhard; Ristić, Arsen D.; Seferović, Petar; Tsang, Teresa S.M.

doi:10.1007/978-3-642-11335-2_2

Cited by 6 publications

(7 citation statements)

References 32 publications

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“…Pericardiocentesis with and without drainage, subxiphoid pericardiostomy and pericardiectomy were performed by standard technique [1], [9], [39], [40]. During interventions and surgery, we assessed size of effusion obtained by drainage and intraoperatively, and its extent; during surgery we also evaluated extent and size of adhesions and calcifications.…”

Section: Methodsmentioning

confidence: 99%

Predictors of tamponade and constriction in patients with pericardial disease undergoing interventional and surgical treatment

Kudaiberdiev¹,

Joshibayev²,

Imanalieva³

et al. 2016

IJC Heart & Vasculature

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ObjectiveThe aim of our study was to define predictors of cardiac compression development including clinical, electrocardiographic, echocardiographic, chest-X-ray and perioperative parameters and their diagnostic value.MethodsOverall 243 patients with pericardial disease, among them 123 with compression (tamponade, constriction) and 120 without signs of compression were included in the study. Clinical, laboratory, electrocardiographic, chest-X-Ray, echocardiographic and perioperative data were included in the logistic regression analysis to define predictors of tamponade/constriction development.ResultsLogistic regression analysis demonstrated large effusion (> 20 mm) (OR 5.393, 95%CI 1.202–24.199, p = 0.028), cardiac chamber collapse (OR 31.426, 95%CI 1.609–613-914, p = 0.023) and NYHA class > 3 (OR 8.671, 95%CI 1.730–43.451, p = 0.009) were multivariable predictors of compression development. The model including these three variables allowed predicting compression in 91.7% of cases.ROC analyses demonstrated that all three variables had significant diagnostic value with sensitivity of 75.6% and specificity of 74.2% for large effusion, low sensitivity and high specificity for cardiac chamber collapse (35% and 92%) and NYHA class (32.5% and 94.2%).ConclusionThe independent predictors of compression development are presence of large effusion > 20 mm, cardiac chamber collapse and high NYHA class. The model including all three parameters allows correctly predicting compression in 91.4% of cases. The diagnostic accuracy of each parameter is characterized by high sensitivity and specificity of large effusion, high specificity of cardiac chamber collapse and NYHA class.

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Section: Methodsmentioning

confidence: 99%

Predictors of tamponade and constriction in patients with pericardial disease undergoing interventional and surgical treatment

Kudaiberdiev¹,

Joshibayev²,

Imanalieva³

et al. 2016

IJC Heart & Vasculature

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“…A higher chance for major complications and mortality was associated with blind guidance. [36,37] Similarly, this approach is employed to deliver pharmacological agents. Generally, there are three routes to access the pericardium, namely subxiphoid, paraapical and parasternal approaches.…”

Section: Subxiphoid Accessmentioning

confidence: 99%

Access routes, devices and guidance methods for intrapericardial delivery in cardiac conditions

Ho¹,

Craig²,

Day³

2022

Trends in Cardiovascular Medicine

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“…For treatment of peri(myo)carditis, we prefer colchicine instead, not only in recurrent forms but also for the first attack [13]. …”

Section: Treatmentmentioning

confidence: 99%

“…Antiphlogistic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or indomethacin should be reserved for patients with pericardial involvement, since in murine coxsackie B3 myocarditis this treatment was shown to be detrimental [ 12 ]. For treatment of peri(myo)carditis, we prefer colchicine instead, not only in recurrent forms but also for the first attack [ 13 ].…”

Section: Treatmentmentioning

confidence: 99%

Treatment options in myocarditis and inflammatory cardiomyopathy

Maisch

Alter

2018

Herz

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For myocarditis and inflammatory cardiomyopathy, an etiologically driven treatment is today the best option beyond heart failure therapy. Prerequisites for this are noninvasive and invasive biomarkers including endomyocardial biopsy and polymerase chain reaction on cardiotropic agents. Imaging by Doppler echocardiography and cardiac magnetic resonance imaging as well as cardiac biomarkers such as C‑reactive protein, N‑terminal pro-B-type natriuretic peptide , and troponins can contribute to the clinical work-up of the syndrome but not toward elucidating the underlying cause or pathogenetic process. This review summarizes the phases and clinical features of myocarditis and gives an up-to-date short overview of the current treatment options starting with heart failure and antiarrhythmic therapy. Although inflammation in myocardial disease can resolve spontaneously, often specific treatment directed against the causative agent is required. For fulminant, acute, and chronic autoreactive myocarditis, immunosuppressive treatment has proven to be beneficial in the TIMIC and ESETCID trials; for viral cardiomyopathy and myocarditis, intravenous immunoglobulin IgG subtype and polyvalent intravenous immunoglobulins IgG, IgA, and IgM can frequently resolve inflammation. However, despite the elimination of inflammation, the eradication of parvovirus B19 and human herpesvirus-6 is still a challenge, for which ivIg treatment can become a future key player.

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Anatomy of the Pericardium Relevant for Pericardial Access, Pericardioscopy, and Intrapericardial Interventions

Cited by 6 publications

References 32 publications

Predictors of tamponade and constriction in patients with pericardial disease undergoing interventional and surgical treatment

Predictors of tamponade and constriction in patients with pericardial disease undergoing interventional and surgical treatment

Access routes, devices and guidance methods for intrapericardial delivery in cardiac conditions

Treatment options in myocarditis and inflammatory cardiomyopathy

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