Safety, Efficacy, and Complications of Pericardiocentesis by Real-Time Echo-Monitored Procedure

Maggiolini, Stefano; Gentile, Gaetano; Farina, Andrea; Carlini, C De; Lenatti, Laura; Meles, Ester; Achilli, Felice; Tempesta, Angela; Brucato, Antonio; Imazio, Massimo

doi:10.1016/j.amjcard.2016.01.043

Cited by 77 publications

(56 citation statements)

References 18 publications

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“…Urgent pericardiocentesis requires great expertise. The number of major complications of echo and fluoro‐guided pericardiocentesis are around 1–2% . The major complications include, mortality, cardiac arrest, cardiac perforation, right coronary perforation, pericardial/epicardial thrombus, injury to an intercostal vessel, pneumothorax, ventricular tachycardia, pulmonary edema, and local/systemic infection …”

Section: Discussionmentioning

confidence: 99%

“…The number of major complications of echo and fluoro-guided pericardiocentesis are around 1-2%. [21][22][23] The major complications include, mortality, cardiac arrest, cardiac perforation, right coronary perforation, pericardial/epicardial thrombus, injury to an intercostal vessel, pneumothorax, ventricular tachycardia, pulmonary edema, and local/systemic infection. [24][25][26][27] In cases of IHTP, until the source of bleeding is stopped, a pericardial hemorrhagic loss can add insult to injury, without the possibility to stabilized the patient.…”

Section: As Reported Inmentioning

confidence: 99%

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Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients

Fiocca

Cereda

Bernelli

et al. 2018

Cathet Cardio Intervent

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Background Iatrogenic hemorrhagic pericardial tamponade (IHPT) represents a life‐threating condition requiring emergency pericardiocentesis. In this clinical context, reinfusion of pericardial blood can stabilize the patient and sustain hemodynamic conditions. Aims and Methods We reviewed all cases of IHPT occurred at our hospital over a 10 years span. In all patient autologous blood reinfusion through a femoral vein was performed. Results In our clinical experience of 30 consecutive patients with hemorrhagic cardiac tamponade, this technique was successful to limit blood transfusions, to prevent further clinical worsening and bridge patients with intractable bleeding, to cardiac surgery. No major adverse reactions were directly related to blood autotransfusion. Conclusion In the complex clinical scenario of acute tamponade occurring during catheter‐based cardiac procedures, autotransfusion of pericardial blood through a femoral vein is safe and effective. It can be a useful trick up the sleeve of the interventional cardiologist.

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Section: Discussionmentioning

confidence: 99%

Section: As Reported Inmentioning

confidence: 99%

Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients

Fiocca

Cereda

Bernelli

et al. 2018

Cathet Cardio Intervent

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“…Ultrasound is useful before, during and after the procedure. Its use has shown to reduce the incidence of major complications, reported as 3%, comparing to the blind subxiphoid approach that has an associated incidence of complications of 5–25% (39–41). Assessment of the effusion must be done from standard views to find the largest area of effusion closest to the transducer avoiding vital structures.…”

Section: Ultrasound-guided Pericardiocentesismentioning

confidence: 99%

Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

et al. 2017

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Pericardial effusion (PEff) is defined by an increase in the physiological amount of fluid within the pericardial space. It can appear following different medical conditions, mainly related to inflammation and cardiac surgery. Cardiac tamponade is a critical condition that occurs after sudden and/or excessive accumulation of fluid in the pericardial space that restricts appropriate filling of the cardiac chambers disturbing normal hemodynamics and ultimately causing hypotension and cardiac arrest. It is, therefore, a life-threatening condition that must be diagnosed as soon as possible for correct treatment and management. Echocardiographic evaluation of PEff is paramount for timely and appropriate diagnosis and management. A structured echocardiographic approach including two-dimensional, M-mode, and Doppler echocardiographic evaluation assessing (i) quantity and quality of pericardial fluid, (ii) collapse of cardiac chambers, (iii) respiratory variation of the ventricular diameters, (iv) inferior vena cava collapsibility, and (v) flow patterns in atrioventricular valves should give the bedside clinician the necessary information to appropriately manage PEff. Here, we review these key echocardiographic signs that will ensure an appropriate assessment of a patient with PEff and/or cardiac tamponade.

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“…The patient's hemodynamic parameters immediately improved following drainage of the pericardial space. [8][9][10] A left-sided chest tube was placed to facilitate removal of the fluid. One liter of bloody fluid was evacuated, which allowed removal of the pericardial drain.…”

Section: Discussionmentioning

confidence: 99%