Computed Tomography-guided Pericardiocentesis: An alternative approach for accessing the pericardium
| Autor: | John Nicholas Melvan, David Madden, Julio C. Vasquez, Jacob DeLaRosa |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Cardiac output Heart Diseases medicine.medical_treatment 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cardiac tamponade Medicine Pericardium Humans Aged business.industry Ultrasound Mediastinum medicine.disease Surgery medicine.anatomical_structure Effusion Pericardiocentesis Hypertension Radiology Tamponade Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed |
| Zdroj: | Heart, lungcirculation. 25(7) |
| ISSN: | 1444-2892 |
| Popis: | Pericardial effusions compress the heart, decrease cardiac output, and lead to haemodynamic collapse. Ultrasound (US)-guided pericardiocentesis is the gold standard for treating pericardial effusions. Recently, the incorporation of computed tomography (CT) guidance has increased patient safety while entering the pericardium. Despite the superior performance of CT-guided pericardiocentesis in smaller, complex effusions, this procedure is not routinely performed by cardiologists and surgeons. Unlike those with an intact pericardium, patients with mediastinal trauma, pericardial adhesions, temporary pacing wires, and vascular conduits are high risk for pericardiocentesis. Tamponade physiology also increases patient susceptibility to the hypotensive effects of anaesthesia during surgical drainage. Here we illustrate the technique of CT-guided pericardiocentesis and demonstrate its application in specific clinical scenarios. We conclude that CT-guided pericardiocentesis provides a useful, alternative strategy for treating cardiac tamponade in high risk patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect