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Rivista sulle Malattie del Cuore e dei Vasi
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2016 Nov 30
Safety and efficacy of non-continuous echocardiographic guided pericardiocentesis: a single-center study of 478 patients
Ilaria BATTISTONI 1, Marco MARINI 1, Luca ANGELINI 1, Matteo FRANCIONI 1, Alberto GILI 1, Stefano MORETTI 1, Carlo COSTANTINI 2, Christian CORINALDESI 1, Marica BORDICCHIA 3, Gian P. PERNA 1 ✉
1 Department of Cardiovascular Disease, “Ospedali Riuniti Hospital”, Ancona, Italy; 2 Department of Cardiovascular Disease, “Ospedali Riuniti Murri Hospital”, Jesi (AN), Italy; 3 Internal Medicine Department of Clinical and Molecular Science, “Marche Polytechnic University”, Ancona, Italy
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis in Italy. The aim of the study was to evaluate safety and efficacy of pericardiocentesis, performed with non-continuous echocardiography monitoring. All the procedures performed at Department of Cardiovascular Disease, Ospedali Riuniti Ancona, from January 2001 to June 2013, were retrospectively analyzed to determine risks connected to the procedure and its success rate. Epidemiological data, procedure indications and etiology of the effusions were also recorded.
METHODS: In the study period, 478 pericardiocentesis were performed for cardiac tamponade (161 cases), to remove large amount of fluid (215 cases) or for diagnostic purposes (102 cases). Echocardiographic evaluation, performed just before the procedure, was used to define the site of entry, to measure the distance from the skin to the fluid, and to establish how to direct the needle.
RESULTS: We observed an extremely low rate of complications (<1%), without any death. The procedure was fully successful in 98% of cases and achieved only partial fluid removal in the remained 10 patients. The etiology of the effusion was malignancy or post cardiothoracic surgery in almost 60% of cases. Over the years there was an increase of pericardiocentesis performed after a cardiothoracic surgery (p=0.002); There was a significant reduction of the average amount of drained fluid in years 2013-2010 vs the years 2009-2001.
CONCLUSIONS: Echo-guided pericardiocentesis is an effective and safe procedure, with a low rate of complications.