Skip to main content
Erschienen in: Herz 2/2015

01.04.2015 | Original article

Echo-guided pericardiocentesis in patients with clinically significant pericardial effusion

Outcomes over a 10-year period

verfasst von: S. Akyuz, MD, A. Zengin, E. Arugaslan, S. Yazici, T. Onuk, U.S. Ceylan, B. Gungor, U. Gurkan, T. Kemaloglu Oz, H. Kasikcioglu, N. Cam

Erschienen in: Herz | Sonderheft 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

The purpose of the present study is to evaluate current echocardiographically (echo)-guided pericardiocentesis practice with regard to procedural success, complication rate, etiological causes, and outcomes of patients with clinically significant pericardial effusion.

Patients and methods

Patients who underwent echo-guided pericardiocentesis between January 2004 and February 2014 were identified using an institutional code for the procedure. Other complementary data were obtained by interviewing patients or their relatives (directly or by telephone) and by searching the social security death index.

Results

A total of 301 patients were identified. The pericardium was approached via the subcostal (85 %) or apical (15 %) route under echo guidance in all procedures. The success rate was 97 %, with an intervention-requiring complication rate of 1.3 %. No patient died from complications. The most common etiology was malignancy (n = 84, 28 %). Patients were followed-up for a median of 35 months. Median survival for patients with malignant effusion was 5.9 months compared with 54 months for those with nonmalignant effusion.

Conclusions

Echo-guided pericardiocentesis has a high success and low complication rate in current practice. Among etiologies, malignancy remains the most common cause of clinically significant pericardial effusion and is associated with a poor prognosis.
Literatur
1.
Zurück zum Zitat Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME et al (2002) Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc 77(5):429–436CrossRefPubMed Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME et al (2002) Consecutive 1127 therapeutic echocardiographically guided pericardiocentesis: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc 77(5):429–436CrossRefPubMed
2.
Zurück zum Zitat Vayre F, Lardoux H, Pezzano M, Bourdarias JP et al (2000) Subxiphoid pericardiocentesis guided by contrast two-dimensional echocardiography in cardiac tamponade: experience of 110 consecutive patients. Eur J Echocardiogr 1(1):66–71CrossRefPubMed Vayre F, Lardoux H, Pezzano M, Bourdarias JP et al (2000) Subxiphoid pericardiocentesis guided by contrast two-dimensional echocardiography in cardiac tamponade: experience of 110 consecutive patients. Eur J Echocardiogr 1(1):66–71CrossRefPubMed
3.
Zurück zum Zitat Neurontin® (gabapentin) Tablets package insert. Parke-Davis Div of Pfizer Inc. http://labeling.pfizer.com/ShowLabeling.aspx?id=630. Accessed: 17 June 2014 Neurontin® (gabapentin) Tablets package insert. Parke-Davis Div of Pfizer Inc. http://​labeling.​pfizer.​com/​ShowLabeling.​aspx?​id=​630.​ Accessed: 17 June 2014
4.
Zurück zum Zitat Veress G, Feng D, Oh JK (2013) Echocardiography in pericardial diseases: new developments. Heart Fail Rev 18(3):267–275CrossRefPubMed Veress G, Feng D, Oh JK (2013) Echocardiography in pericardial diseases: new developments. Heart Fail Rev 18(3):267–275CrossRefPubMed
5.
Zurück zum Zitat Inglis R, King AJ, Gleave M, Bradlow W et al (2011) Pericardiocentesis in contemporary practice. J Invasive Cardiol 23(6):234–239PubMed Inglis R, King AJ, Gleave M, Bradlow W et al (2011) Pericardiocentesis in contemporary practice. J Invasive Cardiol 23(6):234–239PubMed
6.
Zurück zum Zitat Ben-Horin S, Bank I, Guetta V, Livneh A (2006) Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis. Medicine (Baltimore) 85(1):49–53 Ben-Horin S, Bank I, Guetta V, Livneh A (2006) Large symptomatic pericardial effusion as the presentation of unrecognized cancer: a study in 173 consecutive patients undergoing pericardiocentesis. Medicine (Baltimore) 85(1):49–53
7.
Zurück zum Zitat Ma W, Liu J, Zeng Y, Chen S et al (2012) Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz 37(2):183–187CrossRefPubMed Ma W, Liu J, Zeng Y, Chen S et al (2012) Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz 37(2):183–187CrossRefPubMed
8.
Zurück zum Zitat Kil UH, Jung HO, Koh YS, Park HJ et al (2008) Prognosis of large, symptomatic pericardial effusion treated by echo-guided percutaneous pericardiocentesis. Clin Cardiol 31(11):531–537CrossRefPubMed Kil UH, Jung HO, Koh YS, Park HJ et al (2008) Prognosis of large, symptomatic pericardial effusion treated by echo-guided percutaneous pericardiocentesis. Clin Cardiol 31(11):531–537CrossRefPubMed
9.
Zurück zum Zitat Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, Soler-Soler J (2000) Clinical clues to the causes of large pericardial effusions. Am J Med 109(2):95–101CrossRefPubMed Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, Soler-Soler J (2000) Clinical clues to the causes of large pericardial effusions. Am J Med 109(2):95–101CrossRefPubMed
10.
Zurück zum Zitat Levy PY, Corey R, Berger P, Habib G et al (2003) Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore) 82(6):385–391 Levy PY, Corey R, Berger P, Habib G et al (2003) Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore) 82(6):385–391
11.
Zurück zum Zitat Corey GR, Campbell PT, Van Trigt P, Kenney RT et al (1993) Etiology of large pericardial effusions. Am J Med 95(2):209–213CrossRefPubMed Corey GR, Campbell PT, Van Trigt P, Kenney RT et al (1993) Etiology of large pericardial effusions. Am J Med 95(2):209–213CrossRefPubMed
12.
Zurück zum Zitat Pankuweit S, Stein A, Karatolios K, Richter A et al (2013) Viral genomes in the pericardial fluid and in peri- and epicardial biopsies from a German cohort of patients with large to moderate pericardial effusions. Heart Fail Rev 18(3):329–336CrossRefPubMed Pankuweit S, Stein A, Karatolios K, Richter A et al (2013) Viral genomes in the pericardial fluid and in peri- and epicardial biopsies from a German cohort of patients with large to moderate pericardial effusions. Heart Fail Rev 18(3):329–336CrossRefPubMed
13.
Zurück zum Zitat Reuter H, Burgess LJ, Doubell AF (2005) Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect 133(3):393–399CrossRefPubMedCentralPubMed Reuter H, Burgess LJ, Doubell AF (2005) Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect 133(3):393–399CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Ristić AD, Imazio M, Adler Y, Anastasakis A et al (2014) Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J (Epub ahead of print) Ristić AD, Imazio M, Adler Y, Anastasakis A et al (2014) Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J (Epub ahead of print)
15.
Zurück zum Zitat Maisch B, Seferović PM, Ristić AD, Erbel R et al (2004) Guidelines on the diagnosis and management of pericardial diseases-executive summary. Eur Heart J 25(7):587–610CrossRefPubMed Maisch B, Seferović PM, Ristić AD, Erbel R et al (2004) Guidelines on the diagnosis and management of pericardial diseases-executive summary. Eur Heart J 25(7):587–610CrossRefPubMed
16.
Zurück zum Zitat Knockaert DC (2007) Cardiac involvement in systemic inflammatory diseases. Eur Heart J 28(15):1797–1804CrossRefPubMed Knockaert DC (2007) Cardiac involvement in systemic inflammatory diseases. Eur Heart J 28(15):1797–1804CrossRefPubMed
17.
Zurück zum Zitat Maisch B, Rupp H, Ristić A, Pankuweit S (2013) Pericardioscopy and epi- and pericardial biopsy- a new window to the heart improving etiological diagnoses and permitting targeted intrapericardial therapy. Heart Fail Rev 18(3):317–328CrossRefPubMed Maisch B, Rupp H, Ristić A, Pankuweit S (2013) Pericardioscopy and epi- and pericardial biopsy- a new window to the heart improving etiological diagnoses and permitting targeted intrapericardial therapy. Heart Fail Rev 18(3):317–328CrossRefPubMed
18.
Zurück zum Zitat Atar S, Chiu J, Forrester JS, Siegel RJ (1999) Bloody pericardial effusion in patients with cardiac tamponade. Is the cause cancerous, tuberculous, or iatrogenic in the 1990s? Chest 116:1564–1569CrossRefPubMed Atar S, Chiu J, Forrester JS, Siegel RJ (1999) Bloody pericardial effusion in patients with cardiac tamponade. Is the cause cancerous, tuberculous, or iatrogenic in the 1990s? Chest 116:1564–1569CrossRefPubMed
19.
Zurück zum Zitat Maich B, Ristić AD, Seferović PM, Tsang TS (2011) Interventional pericardiology. Springer, Heidelberg, S 144–146 Maich B, Ristić AD, Seferović PM, Tsang TS (2011) Interventional pericardiology. Springer, Heidelberg, S 144–146
20.
Zurück zum Zitat Maisch B, Ristić AD, Pankuweit S (2002) Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone: the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J 23:1503–1508CrossRefPubMed Maisch B, Ristić AD, Pankuweit S (2002) Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone: the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J 23:1503–1508CrossRefPubMed
21.
Zurück zum Zitat Karatolios K, Pankuweit S, Maisch B (2013) Diagnostic value of biochemical biomarkers in malignant and non-malignant pericardial effusion. Heart Fail Rev 18(3):337–344CrossRefPubMed Karatolios K, Pankuweit S, Maisch B (2013) Diagnostic value of biochemical biomarkers in malignant and non-malignant pericardial effusion. Heart Fail Rev 18(3):337–344CrossRefPubMed
22.
Zurück zum Zitat Ristić AD, Pankuweit S, Maksimović R, Moosdorf R et al (2013) Pericardial cytokines in neoplastic, autoreactive, and viral pericarditis. Heart Fail Rev 18(3):345–353CrossRefPubMed Ristić AD, Pankuweit S, Maksimović R, Moosdorf R et al (2013) Pericardial cytokines in neoplastic, autoreactive, and viral pericarditis. Heart Fail Rev 18(3):345–353CrossRefPubMed
Metadaten
Titel
Echo-guided pericardiocentesis in patients with clinically significant pericardial effusion
Outcomes over a 10-year period
verfasst von
S. Akyuz, MD
A. Zengin
E. Arugaslan
S. Yazici
T. Onuk
U.S. Ceylan
B. Gungor
U. Gurkan
T. Kemaloglu Oz
H. Kasikcioglu
N. Cam
Publikationsdatum
01.04.2015
Verlag
Urban & Vogel
Erschienen in
Herz / Ausgabe Sonderheft 2/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-014-4187-x

Weitere Artikel der Sonderheft 2/2015

Herz 2/2015 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.