The risk of pericardiocentesis

Wong, Bert Y.S.; Murphy, Jay; Chang, Chau-Shiung; Hassenein, Khatab; Dunn, Marvin

doi:10.1016/0002-9149(79)90176-0

Cited by 122 publications

(68 citation statements)

References 15 publications

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“…7,20 Furthermore, in cases of purulent and chronic idiopathic PE, echo-guided pericardiocentesis is known as a simple and safe therapeutic method. 1,2,5,6,9,10,13,15,17,18,21 In addition to therapeutic safety, our success rate was very high (99.1%). These results showed that echo-guided pericardiocentesis is very safe and is the effective treatment for large, symptomatic PE.…”

Section: Discussionmentioning

confidence: 66%

“…9 However, echocardiograpic guidance increases the success rate of pericardiocentesis by reducing these complications. 6,10,11 The experiences of PE and echo-guided percutaneous pericardiocentesis from several centers have been published. 2,12 -16 But the data on Koreans, or the far east Asians, is rare and the prognosis according to etiology is not dictated in any of the articles.…”

Section: Introductionmentioning

confidence: 99%

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Prognosis of Large, Symptomatic Pericardial Effusion Treated by Echo‐guided Percutaneous Pericardiocentesis

Kil

Jung

Koh

et al. 2008

Clinical Cardiology

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Backgrounds:The causes and prognosis of pericardial effusion (PE) may be different according to time, region, economy, and hospital. This study was performed to evaluate the etiology, clinical outcome, and prognosis of patients with large, symptomatic PE treated by echo-guided pericardiocentesis at Kangnam St. Mary's Hopital (the Catholic University of Korea, Seoul, Korea). Hypothesis: According to etiologies of large, symptomatic PE, the prognosis of patients may be different. Methods: We reviewed 116 consecutive patients who underwent echo-guided pericardiocentesis due to large, symptomatic PE over the last 12 y. The Kaplan-Meier survival curve with log-rank method was applied for the survival analysis.Results: Procedural success rate of echo-guided pericardiocentesis was 99.1%. Common causes of PE requiring pericardiocentesis were lung cancer (27.6%), tuberculosis (TB) (13.8%), and uremia (6.9%). The mortality rate of 6 mo after the pericardiocentesis was 80.3% in malignant PE, whereas the over-all mortality rate was 18.2% in nonmalignant PE (p<0.0001). Among the malignant PE, lung cancer (27.6%) and breast cancers (6.9%) were the most common causes. The mean cytologic detection rate and mean life expectancy of malignant PE were 44% and 5-7 mo. Patients with breast cancer and lymphoma had relatively better life expectancy (11.4 and 7.7 mo), whereas those with stomach cancer and metastases of unknown origin (MUO) had poorer prognosis (1.2 and 2.3 mo). The most common causes of nonmalignant PE were TB, uremia, and iatrogenic, and their mean life expectancy was approximately 54 mo. Conclusions: Malignancy, especially lung cancer and TB, were the most common causes of large symptomatic PE. The prognosis of large symptomatic PE was related to the underlying disease. Malignant PE was associated with the poorest prognosis.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Prognosis of Large, Symptomatic Pericardial Effusion Treated by Echo‐guided Percutaneous Pericardiocentesis

Kil

Jung

Koh

et al. 2008

Clinical Cardiology

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“…10,11,13 If ultrasound is unavailable and the patient demonstrates strong evidence of cardiac tamponade, a blind pericardiocentesis utilizing a subxiphoid approach can be considered, although it is associated with higher complication rates than ultrasound-guided pericardiocentesis. 39 With this approach, the sheath needle is placed in the angle between the xiphisternum and the left costal margin and advanced toward the left shoulder. The needle is directed at 30 to 45 degrees cranially until it is past the costal margin, where the angle is decreased to 15 to 30 degrees and advanced into the pericardium.…”

Section: Treatment Of Rupture and Tamponadementioning

confidence: 99%

Superior Vena Cava Rupture and Cardiac Tamponade Complicating the Endovascular Treatment of Malignant Superior Vena Cava Syndrome: A Case Report and Literature Review

Stevens

Butty

Johnson

2015

Semin intervent Radiol

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A 47-year-old man with known metastatic small cell lung cancer presented with 1 week of right arm swelling, facial flushing, shortness of breath, right hand weakness, and intermittent blurry vision. Physical examination revealed right upper extremity edema and facial plethora. Computed tomography (CT) of the chest confirmed enlargement of a right upper lobe mass causing near-complete occlusion of the right brachiocephalic vein and superior vena cava (SVC) (►Fig. 1), consistent with SVC syndrome (SVCS). After extensive discussion regarding the risks and benefits of the procedure, the patient elected to proceed with endovascular reconstruction of the central veins.Bilateral basilic vein access was obtained, and digital upper extremity venography confirmed near-complete occlusion of the SVC (►Fig. 2). The occlusion was traversed using a 0.035-inch wire and a 5F catheter, and intraluminal crossing was confirmed with contrast injection. Throughand-through access was obtained via the right common femoral vein, and the SVC and brachiocephalic veins were dilated using 8-and 10-mm balloons (►Fig. 3). Venogram immediately following the 10-mm angioplasty demonstrated contrast extravasation into the mediastinum and likely the pericardial space, indicative of SVC rupture (►Fig. 4). Ultrasound revealed a thin pericardial effusion, which, given the patient's history of radiation, was deemed sufficient to cause tamponade. Overlapping 13 mm Â 5 cm Viabahn-covered stents (Gore Medical, Flagstaff, AZ) were placed from the central aspect of the left brachiocephalic vein to the atriocaval junction (►Fig. 5). However, the patient rapidly decompensated, and despite aggressive resuscitation following advanced cardiac life support (ACLS) protocol, including pericardiocentesis, the patient expired on the table.

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“…Surgical placement of subxiphoid tube is the preferred technique for draining a small amount of effusion in patients with quickly developing pericardial tamponade such as those with acute traumatic hemopericardium [7,8]. For patients with massive effusion and slowly developing pericardial tamponade, there are 2 principal methods: percutaneous catheter drainage and surgical tube drainage [9][10][11][12]. A major risk of percutaneous pericardiocentesis is laceration of the heart, coronary arteries, or lungs.…”

Section: Introductionmentioning

confidence: 99%

“…A major risk of percutaneous pericardiocentesis is laceration of the heart, coronary arteries, or lungs. If needle pericardiocentesis is performed at the bed side without echocardiographic guidance or hemodynamic monitoring, the risk of life threatening complications is as high as 20% [12]. Echocardiographic guidance increases the success rate of pericardiocentesis by reducing this complication [13].…”

Section: Introductionmentioning

confidence: 99%

Clinico-Etiological Profile of Cardiac Tamponade in a Tertiary Care Centre

Setty¹

2016

J Cardiovasc Med Cardiol

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The risk of pericardiocentesis

Cited by 122 publications

References 15 publications

Prognosis of Large, Symptomatic Pericardial Effusion Treated by Echo‐guided Percutaneous Pericardiocentesis

Prognosis of Large, Symptomatic Pericardial Effusion Treated by Echo‐guided Percutaneous Pericardiocentesis

Superior Vena Cava Rupture and Cardiac Tamponade Complicating the Endovascular Treatment of Malignant Superior Vena Cava Syndrome: A Case Report and Literature Review

Clinico-Etiological Profile of Cardiac Tamponade in a Tertiary Care Centre

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