Evolution of the pericardiocentesis technique

Maggiolini, Stefano; Carlini, C De; Imazio, Massimo

doi:10.2459/jcm.0000000000000649

Cited by 24 publications

(34 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Procedural ultrasound guidance has become the standard of care when performing pericardiocentesis as treatment of cardiac tamponade. It has been found to be safe, effective, and easy to perform, with minimal complications and increased success rates, even in patients with coagulopathy and thrombocytopenia [6,10]. Typical approaches include subxiphoid, apical, and parasternal.…”

Section: Discussionmentioning

confidence: 99%

“…Typical approaches include subxiphoid, apical, and parasternal. However, the apical approach is typically avoided due to a higher risk of ventricular puncture [6]. Utilization of POCUS has been found to provide rapid, noninvasive differentiation of shock as well as reduce procedural complications and improve patient safety [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Bedside pericardiocentesis was historically performed via the subxiphoid approach. However, ultrasound-guided pericardiocentesis (UGP) has been performed since 1979 and has been widely documented to be safe and efficacious for the management of cardiac tamponade [6]. Here, we present a case of cardiac tamponade post-OLT with successful UGP via a lateral-apical approach.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lateral-Apical Approach to Pericardiocentesis for Treatment of Cardiac Tamponade Immediately Post-orthotopic Liver Transplantation

Santos¹,

Propst²,

Canabal³

et al. 2021

Cureus

View full text Add to dashboard Cite

Cardiac tamponade is a rare complication following orthotopic liver transplantation (OLT). The incidence and treatment specific to the immediate postoperative OLT patient have never been reported. Here, we describe a case of OLT complicated by coagulopathy and difficult intraoperative pulmonary artery catheter placement with subsequent postoperative hemopericardium resulting in tamponade. An emergent, ultrasound-guided, lateral-apical pericardiocentesis was successfully performed, suggesting a possible procedural technique for pericardiocentesis in the immediate postoperative period for liver transplant patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lateral-Apical Approach to Pericardiocentesis for Treatment of Cardiac Tamponade Immediately Post-orthotopic Liver Transplantation

Santos¹,

Propst²,

Canabal³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Since its rst introduction, ultrasound-guided pericardiocentesis procedure has been re ned and shaped into better techniques with different approaches [4]. The older practice used echocardiography to diagnose pericardial effusion and locate the best site for puncture [5]. This method, known as echocardiography-assisted pericardiocentesis, does not provide continuous ultrasound visualization of needle trajectory.…”

Section: Introductionmentioning

confidence: 99%

“…This method, known as echocardiography-assisted pericardiocentesis, does not provide continuous ultrasound visualization of needle trajectory. The newer approach is a true echocardiography-guided procedure that uses ultrasound transducer to guide the needle, allowing the clinician to avoid injury to surrounding structures [5,6]. This is a case report of our experience with a novel subcostal in-plane ultrasound-guided pericardiocentesis using linear transducer for a patient with cardiac tamponade in the emergency department (ED).…”

Section: Introductionmentioning

confidence: 99%

A Novel Ultrasound-guided With Needle Visualization Pericardiocentesis Via Subcostal Approach

Adi¹,

Shamsudin

Fong

et al. 2021

Preprint

View full text Add to dashboard Cite

Cardiac tamponade is a condition when fluids or blood fill the pericardial space resulting in compression of the heart and subsequently compromising hemodynamic status of the patient. It is a potentially fatal medical or traumatic emergency that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used to aspirate the pericardial fluid and they were associated with plenty of risks and complications. In the recent era, medical technology development has enabled us to perform the procedure safely with the assistance of ultrasound devices. The ultrasound-guided procedure is not only proven to be effective and safe, but it also has very minimal drawbacks and complications. In the literature, there are many ultrasound-guided pericardiocentesis procedures performed with different approaches at different regions. They include subcostal, parasternal, and para-apical approaches and phased array echocardiography transducers are typically preferred for the procedures. We report a case of cardiac tamponade presented with hemodynamic compromise. Ultrasound-guided pericardiocentesis was carried out using in-plane technique with high frequency linear ultrasound transducer at the subcostal region as lifesaving procedure. This particular technique provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient’s hemodynamic status improved post-procedure. This article highlights the novel use of in-plane method with high frequency linear transducer at subcostal area as a safe option for pericardiocentesis in patients with cardiac tamponade.

show abstract

High frequency ultrasound‐guided pericardiocentesis performed in the sitting position: A novel apical approach

Zhang

Liu

et al. 2021

Clinical Cardiology

View full text Add to dashboard Cite

Background So far, few approaches have been described to reduce inadvertent injury to structure of the heart and nearby organs in percutaneous pericardiocentesis. Hypothesis We hypothesized that an in‐plane high frequency ultrasound‐guided apical approach, performed in the sitting position, would provide additional benefits in terms of feasibility and safety for draining malignant pericardial effusion (MPE). Methods The authors selected 53 consecutive patients with moderate or large symptomatic MPE who underwent high frequency ultrasound‐guided pericardiocentesis. After the procedure, all patients were followed for 90 days with the main purpose of detecting procedure success, procedure‐related complications, and recurrent PE. Results Procedure success rate for pericardiocentesis was 100%. All patients were placed in the sitting position with their left hands extended above the heads. An apical puncture approach was performed in all cases (100%). The mean duration of catheter drainage was 8.1 ± 3.2 days. The mean initial amount of pericardial fluid drained was 956.3 ± 687.5 ml. Overall, six patients (11%) had recurrent PE; 3 (6%) had repeated percutaneous pericardiocentesis. There was no major complication and minor complications occurred in four patients (8%). Conclusion This novel in‐plane high frequency US‐guided apical approach has several advantages for percutaneous pericardiocentesis of MPE: performed in the sitting position; a benefit for patients with orthopnea; a maximum inserted wide angle to prevent damage to the myocardium; local enlargement of the PE region; high procedure success rate of pericardiocentesis; and excellent clinical outcomes.

show abstract

Evolution of the pericardiocentesis technique

Cited by 24 publications

References 40 publications

Lateral-Apical Approach to Pericardiocentesis for Treatment of Cardiac Tamponade Immediately Post-orthotopic Liver Transplantation

Lateral-Apical Approach to Pericardiocentesis for Treatment of Cardiac Tamponade Immediately Post-orthotopic Liver Transplantation

A Novel Ultrasound-guided With Needle Visualization Pericardiocentesis Via Subcostal Approach

High frequency ultrasound‐guided pericardiocentesis performed in the sitting position: A novel apical approach

Contact Info

Product

Resources

About