Pericardiocentesis

Summary

The prevalence of pericardial effusion and cardiac tamponade is growing. This may reflect increasing survival of patients with advanced malignant disease and performance of increasingly complex cardiac interventions. Thus the management of pericardial effusions and cardiac tamponade are common challenges for today’s cardiologist. Furthermore, interventional cardiology is recognising the diagnostic and therapeutic potential of percutaneously accessing the pericardial space for drug delivery, pericardial biopsy, epicardial mapping and ablation of arrhythmogenic circuits.

This chapter describes a step-by-step approach to performing pericardiocentesis and provides an overview of procedural complications and patient management.

(The prevention and management of complications during percutaneous coronary intervention)

We describe approaches to the prevention and management of recurrent pericardial effusion and illustrate techniques such as percutaneous balloon pericardiotomy and other novel percutaneous pericardial procedures.

Introduction

The pericardial space, which lies between the inner visceral pericardium and the outer fibrous parietal pericardium, surrounds the heart and normally contains up to 50 mls of serous fluid 11. Braunwald’s Heart Disease – A textbook of Cardiovascular Medicine Seventh Edition. Edited by Zipes DP, Libby P, Bonow RO, Braunwald E. Elsevier Saunders. 2005. p. 1757. Link. The pressure in this space varies between -5 cm and +5 cm...