to evaluate the safety and feasibility of echo-guided pericardiocentesis using central venous catheter, we consecutively performed 33 emergency pericardiocenteses in 28 patients with cardiac tamponade or impending tamponade.
Two-dimensional (2D) echocardiography was performed in all patients for determination of centesis site. Central venous pressure and intrapericardial pressure were measured before and after pericardiocentesis.
Distribution of pericardial effusion was circumferential in all, swing heart was observed in 31 (91%), diastolic of RA in 30(90%), and diastolic collapse of RV in 19 (58%) cases. Causes of pericardial effusio were adjacent malignancy in 10 (36%),
tuberculous origin in 7(25%), trauma in 2 (7%) , bacterial infection in 2(7%), bacterial infection in 2(7%), uremia in 1(4%), and undetermined cause in 6(21%) cases. Puncture site was subcostal in 24 (73%), apical in 8 (24%), and parasternal in
1(3%)
case.
the central venous pressure and intrapericardial pressure were decreased from 18±5 cmH2O to 7±3 cmH2O and 18±6 cmH2O to 6±3 cmH2O respectively after drainage
Procedure-related complications were inadvertent puncture of pleural space in 2 cases and ventricle in 1 cases without significant hemodynamic compromise.
In conclusion, echocaridiographically guided-pericardiocentesis using central venous catheter is safe and effective means to select the centesis site, to evaluate the adequacy of drainage, and to detect the procedure-related complications in
patients
with cardiac tamponade or impending tamponade.
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