Pericardial Effusion and Pericardial Compartments after Open Heart Surgery

Duvernoy, Olov; Larsson, Sven; Persson, Kristina; Thurén, J.; Wikström, Gerhard

doi:10.3109/02841859009173050

Cited by 3 publications

(5 citation statements)

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“…This so called “Anterior approach” to epicardial access is performed via puncturing this potential space. Additionally, consistent with Archimedes’ principle of buoyancy, increased accumulation of pericardial fluid has been noted in the region anterior to the right ventricle (RV) of nonsurgical hearts in the supine position . In the supine position, the pericardial fluid tends to accumulate anteriorly.…”

Section: Introductionmentioning

confidence: 53%

“…Additionally, consistent with Archimedes' principle of buoyancy, increased accumulation of pericardial fluid has been noted in the region anterior to the right ventricle (RV) of nonsurgical hearts in the supine position. 11,12 In the supine position, the pericardial fluid tends to accumulate anteriorly. Gale et al showed in a series of 68 patients with pericardial effusion that the fluid was located solely or predominantly anterior to the RV.…”

Section: Introductionmentioning

confidence: 99%

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Anterior pericardial access to facilitate electrophysiology study and catheter ablation of ventricular arrhythmias: A single tertiary center experience

Keramati

DeMazumder

Misra

et al. 2017

Cardiovasc electrophysiol

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Introduction Epicardial ablation is becoming an important part of management in patients with ventricular tachycardia (VT). Posterior epicardial access via the Sosa or needle-in-needle (NIN) approach for epicardial VT ablation is considered to be the method of choice for most electrophysiologists. Anterior epicardial access as an alternative technique has recently been proposed, but there are limited data about its safety, efficacy, and the rate of immediate complications. In this study, we report our experience with anterior epicardial access between 2009 and 2016. Methods Between 2009 and June 2016, 100 consecutive patients underwent epicardial VT ablation using an anterior approach. The success rate, epicardial bleeding, and other complications related to the epicardial access in these patients were compared to the previously reported rate of complications in patients whom epicardial access was performed using the NIN or Sosa techniques. Results Anterior epicardial access was obtained successfully in 100% of patients in the first attempt. The success rate of the anterior approach was comparable with the reported success rate of the NIN technique (100% vs. 100%, P value not significant) but better than the Sosa technique (100% vs. 94%, P = 0.012). None of the patients in the anterior approach series suffered from significant pericardial bleeding (defined as greater than 80 mL of blood loss), RV puncture/damage, or need for an emergent cardiac surgery. Conclusion An anterior epicardial approach is feasible and appears to have an acceptable safety profile in comparison with other epicardial approaches.

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Section: Introductionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Anterior pericardial access to facilitate electrophysiology study and catheter ablation of ventricular arrhythmias: A single tertiary center experience

Keramati

DeMazumder

Misra

et al. 2017

Cardiovasc electrophysiol

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“…Two of the surgical patients with perforations had to undergo thoracotomy and here the cardiac perforation was considered a major complication. In one of these 2 patients postoperative compartments pre vented adequate draining (4). In the other patient the cardi ac perforation caused a laceration of the posterior descend ing branch of the right coronary artery.…”

Section: Discussionmentioning

confidence: 97%

“…Beside these non-surgical aetiologies, pericardial effusion may oc cur at various times after cardiac surgery. In the latter cases the effusion may be trapped in compartments rendering its evaluation and evacuation difficult (4,13).…”

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confidence: 99%

Complications of Percutaneous Pericardiocentesis under Fluoroscopic Guidance

Duvernoy¹,

Borowiec²,

Helmius³

et al. 1992

Acta Radiol

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Complications in 352 cases of fluoroscopy-guided percutaneous pericardiocentesis accomplished through an indwelling catheter were reviewed following surgery and non-surgery. Thirteen major complications were found, namely 3 cardiac perforations, 2 cardiac arrhythmias, 4 cases of arterial bleeding, 2 cases of pneumothorax in children, one infection, and one major vagal reaction. No significant difference in complications was found between pericardiocenteses for pericardial effusions after cardiac surgery (n = 208) and those for effusions of non-surgical (n = 144) origin. Fluoroscopy-guided pericardiocentesis by the subxiphoid approach with placement of an indwelling catheter is a safe method for achieving pericardial drainage in both surgical and non-surgical effusions. Accidental cardiac perforation with a fine needle is a minor complication as long as the needle is directed towards the anterior diaphragmatic border of the right ventricle and drainage is achieved with a reliable indwelling catheter.

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“…CT of the pericardium provides good information about the distribution of pericardial fluid (3). In echocardi ography postoperative mediastinal emphysema and pain from the wound may impair ultrasonic imag ing.…”

mentioning

confidence: 99%