Percutaneous Therapy in Pericardial Diseases

Maisch, Bernhard; Ristić, Arsen D.; Pankuweit, Sabine; Seferović, Petar

doi:10.1016/j.ccl.2017.07.010

Cited by 19 publications

(24 citation statements)

References 114 publications

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“…10,11,16,17 Fibrosis and adhesions can also be appreciated by pericardioscopy in patients with persistently elevated right atrial pressures after pericardiocentesis. 15,18…”

Section: Pathophysiology Of Ecpmentioning

confidence: 99%

“…Assessment of the underlying etiologies, particularly tuberculosis in the African countries, and determination of rheuma serology, for example, antinuclear antibodies, extractable nuclear antibodies and cardiac autoantibodies, antimyolemmal antibodies (AMLA) and antifibrillary antibodies (AFA), complete the clinical assessment and point to an autoreactive etiology. 1,17,18,25…”

Section: Laboratory Findingsmentioning

confidence: 99%

“…Epicardial and pericardial biopsies taken in the context of pericardiocentesis are the suitable diagnostic tool to exclude or prove a viral etiology by PCR 3,15 and lead the way to corticoid and immunosuppressive treatment. 18,19 A cardiac center performing pericardiocentesis and peri-and epicardial biopsies should have at least 2 institutional features: a pericardiologist experienced in biopsy performance and pericardiocentesis and a dedicated laboratory to perform histology, immunocytochemistry and molecular techniques such as PCR on cardiotropic agents in biopsy specimens. control.…”

Section: Cardiac Biopsies and Fluid Analysismentioning

confidence: 99%

“…With these techniques, it is nowadays possible to avoid the virtually unhelpful diagnosis of "idiopathic" ECP. 18 etiological factors in pericardial effusion and eCP…”

Section: Cardiac Biopsies and Fluid Analysismentioning

confidence: 99%

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Effusive-constrictive pericarditis: current perspectives

Maisch¹

2018

JVD

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Effusive-constrictive pericarditis (ECP) is defined by concurrent pericardial effusion and pericardial constriction. Whereas the pericardial cavity is typically obliterated in patients with constrictive pericarditis without any effusion, in patients with ECP the scarred pericardium not only constricts the cardiac volume but can also put pericardial fluid under increased pressure, leading to signs suggestive of cardiac tamponade. These hemodynamic features can persist even after the pericardial effusion is removed. The underlying pathogenetic process predominantly involves the visceral pericardium or epicardium. It combines visceral pericardial constriction with pericardial inflammation. Its etiology may be as variable as the causes of effusive or constrictive pericardial disease, which may be infective (e.g., bacterial or viral), malignant or autoreactive. The label idiopathic ECP should be avoided and restricted to only those cases in whom, after thorough clinical and pathological workup including PCR for microbial agents in pericardial fluid and cardiac tissue from peri-and epicardial or endomyocardial biopsies and the assessment of autoimmune processes, no definite diagnosis can be made. Since a considerable number of ECP patients have an inflammatory and reversible pericardial reaction, they can improve under causal and/or anti-inflammatory treatment. The treatment should therefore be based first on eradicating the underlying etiological factors. If such a treatment course remains ineffective, pericardiectomy including the removal of the visceral pericardium is the remaining therapeutic option.

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“…10,11,16,17 Fibrosis and adhesions can also be appreciated by pericardioscopy in patients with persistently elevated right atrial pressures after pericardiocentesis. 15,18…”

Section: Pathophysiology Of Ecpmentioning

confidence: 99%

Section: Laboratory Findingsmentioning

confidence: 99%

Section: Cardiac Biopsies and Fluid Analysismentioning

confidence: 99%

“…With these techniques, it is nowadays possible to avoid the virtually unhelpful diagnosis of "idiopathic" ECP. 18 etiological factors in pericardial effusion and eCP…”

Section: Cardiac Biopsies and Fluid Analysismentioning

confidence: 99%

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Effusive-constrictive pericarditis: current perspectives

Maisch¹

2018

JVD

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“…10 ml Xylocain) wird eine kleine Stichinzision im Winkel zwischen Processus xiphoideus und linkem Rippenbogen durchgeführt und dann mit einer Punktionsnadel im flachen Winkel von 10 -20°in Richtung auf das linke Ohr bzw. die Mitte der linken Klavikula hin punktiert[12]. Dabei sollte auf eine ausreichende Länge der Punktionsnadel (mind.…”

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Perikardpunktion – Schritt für Schritt

Ferrari¹

2019

Pneumologie

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The BALTO Registry: Long‐term results of percutaneous BALloon pericardioTomy in oncological patients

Rivero‐Santana,

Jimenez‐Valero,

Jurado‐Roman

et al. 2024

Cathet Cardio Intervent

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ObjectivesThe aim of this study was to analyze the efficacy and safety of percutaneous balloon pericardiotomy (PBP) in oncological patients who present with a malignant pericardial effusion (MPE).BackgroundThe use of PBP as a treatment for MPE is not standardized due to the limited evidence. Furthermore, the performance of a second PBP for a recurrence after a first procedure is controversial.MethodsThe BALTO Registry (BALloon pericardioTomy in Oncological patients) is a prospective, single‐center, observational registry that includes consecutive PBP performed for MPE from October 2007 to February 2022. Clinical and procedural, characteristics, as well as clinical outcome were analyzed.ResultsSeventy‐six PBP were performed in 61 patients (65% female). Mean age was of 66.4 ± 11.2 years. In 15 cases, a second PBP procedure was performed due to recurrence despite the first PBP. The procedure could be performed effectively in all cases with only two serious complications. Ninety‐five percent of cases were discharged alive from the hospital. During a median follow‐up of 6.3 months (interquartile range [IQR], 0.9–10.8), MPE recurred in 24.5% cases although no recurrences were reported after the second procedure. No evidence of malignant pleural effusion developed on follow‐up. The median overall survival time was 5.8 months (IQR, 0.8–10.2) and the time to recurrence after the first PBP was 2.4 months (IQR, 0.7–4.5).ConclusionsPBP is a safe and effective treatment for MPE. It could be considered an acceptable therapy in most MPE, even in those who recur after a first procedure.

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Percutaneous Therapy in Pericardial Diseases

Cited by 19 publications

References 114 publications

Effusive-constrictive pericarditis: current perspectives

Effusive-constrictive pericarditis: current perspectives

Perikardpunktion – Schritt für Schritt

The BALTO Registry: Long‐term results of percutaneous BALloon pericardioTomy in oncological patients

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