Treatment of Uræmic Pericarditis by Anterior Pericardiectomy

Ali-Regiaba, Sabih; Sullivan, JohnF.; Tapia, Luis; David, DavidS.; White, RobertP.; Stenzel, K. H.; Riggio, Robert R.; Cheigh, Jhoong S.; Rubin, A. L.

doi:10.1016/s0140-6736(74)91347-6

Cited by 23 publications

(10 citation statements)

References 18 publications

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“…3 where systemic steroids were employed [2,3]. Pericardiectomy or pericardial fenestration is immediately effective and almost universally suc cessful; however, the procedure requires a thoracotomy and therefore subjects the patient to the complications and prolonged hospitalization related to the surgical procedure itself [6,13]. OurcaseNo.…”

Section: Discussionmentioning

confidence: 99%

Uremic Pericardial Effusion

Buselmeier

Simmons

Najarían

et al. 1976

Nephron

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Pericardial drainage via percutaneous catheter placement and local nonabsorbable steroid instillation was employed as definitive therapy for uremic patients who had intractable pericardial effusions. Twelve patients are reported. Prior daily dialysis, and in one case systemic steroids, were not curative. 11 of 12 cases suffered severe tamponade requiring pericardiocentesis. One patient had an organized pericardial effusion, making pericardiocentesis impossible. He required pericardiectomy with prolonged hospitalization (2 weeks) due to postoperative complications. There were no complications in the 11 patients where catheter drainage and local steroid instillation were employed. No patient had recurrence of his pericardial effusion (followed from 2 weeks to 32 months). Instillation of a relatively nonabsorbable steroid through an indwelling pericardial catheter provides immediate and lasting relief without either the inconvenience or postoperative complications and prolonged hospitalization associated with the surgical procedure of pericardial fenestration. This report offers initial evidence that the percutaneous approach may be a safe and effective alternative to pericardial fenestration in most uremic patients with pericardial effusion.

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Section: Discussionmentioning

confidence: 99%

Uremic Pericardial Effusion

Buselmeier

Simmons

Najarían

et al. 1976

Nephron

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“…EKG changes, like the friction rub, can be dynamic . However, these classic EKG findings are only found in a minority of ESRD patients with pericarditis with most studies in dialysis patients reporting nonspecific EKG changes; only 1–10% having classic ST elevation . In fact, the European Society of Cardiology (ESC) guidelines from 2004 note that classic EKG changes of pericarditis are usually not present in patients with ESRD and if present should raise concern for concomitant infection .…”

Section: Diagnosismentioning

confidence: 99%

“…While pericardial effusion is generally thought to occur secondary to inflammation, fluid overload may also contribute to this as suggested by the frequent presence of other signs of excess fluid on imaging studies . For example, pleural effusions are noted in 40–75% of ESRD patients with pericarditis and are thought to represent a combination of serositis and generalized fluid overload associated with ESRD .…”

Section: Diagnosismentioning

confidence: 99%

“…Creation of a larger pericardial window, sometimes via an anterior thoracotomy, is termed partial pericardiectomy. Early studies in the 1970s showed success with anterior pericardiectomy in dialysis‐associated pericarditis and accompanying pericardial effusion . Later studies with a less invasive thoracoscopic approach have continued to show a high cure rate with low recurrence of pericarditis and pericardial effusion with minimal complications .…”

Section: Managementmentioning

confidence: 99%

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Pericarditis and Pericardial Effusions in End‐Stage Renal Disease

Dad

Sarnak

2016

Seminars in Dialysis

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Pericarditis and pericardial effusions are not uncommon in patients with end-stage renal disease (ESRD). Etiologies include those found in the general population along with two entities unique to patients with kidney disease, namely uremic and dialysis-associated pericarditis. Uremic pericarditis has been arbitrarily defined as pericarditis that develops before or within 8 weeks of initiation of dialysis, while dialysis-associated pericarditis is used to define pericarditis in patients on dialysis for more than 8 weeks. Retention of uremic toxins is likely a major contributor to uremic and dialysis-associated pericarditis although their exact cause is not known. Indeed, whether they are actually distinct entities is uncertain. Symptoms and signs of pericarditis differ in patients with ESRD compared to the non-ESRD population. Management has not been well studied and ranges from initiation and intensification of dialysis to percutaneous or open drainage for large effusions. This review covers the literature on this topic but emphasizes that most of the data are old and of relatively poor quality, and therefore additional research is needed.

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“…Ή συμμετοχή τών λοι μωδών επιπλοκών εις τήν γένεσιν τής περικαρδίτιδος έγκειται είς τόν συνδυασμόν των μέ άλλους κλινικούς ή βιολογικούς παράγοντες ευνοϊ κούς διά τήν έγκατάστασίν της (δπως ή ύπερυδάτωσις) καί είς τήν παρόξυνσιν προϋπαρχουσών μεταβολικών ανωμαλιών (ύπερφωσφοραιμίας, ύπερουριχαιμίας) συνεπεία αζωτούχου ύπερκαταβολισμοΰ. 3 Ή βαρότης τής νεφρικής ανεπαρκείας δύναται νά κριθή είς πολλαπλά επίπεδα:…”

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Οξεια Περικαρδιτις Εις Ουραιμικους Ασθενεις Υπο Χρονιαν Εξωνεφρικην Καθαρσιν. (Μελετη 37 Περιπτωσεων)

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Treatment of Uræmic Pericarditis by Anterior Pericardiectomy

Cited by 23 publications

References 18 publications

Uremic Pericardial Effusion

Uremic Pericardial Effusion

Pericarditis and Pericardial Effusions in End‐Stage Renal Disease

Οξεια Περικαρδιτις Εις Ουραιμικους Ασθενεις Υπο Χρονιαν Εξωνεφρικην Καθαρσιν. (Μελετη 37 Περιπτωσεων)

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