Related Experiment Videos
Flexible percutaneous pericardioscopy: inherent drawbacks and recent advances
P M Seferovic1, A D Ristić, R Maksimovic
1University Institute for Cardiovascular Diseases, Medical Center of Serbia, Belgrade, Yugoslavia. eseferov@eunet.yu
Herz
|February 24, 2001
Summary
Pericardioscopy, a minimally invasive procedure, significantly enhances the diagnostic value of pericardial biopsies by improving visualization and sampling. This technique, particularly with air instillation, proves safe and effective for diagnosing pericardial diseases.
Area of Science:
- Cardiology
- Endoscopy
- Diagnostic Procedures
Background:
- Pericardial effusions require accurate diagnosis for effective management.
- Traditional pericardial biopsy methods may have limitations in diagnostic yield and visualization.
Purpose of the Study:
- To evaluate the feasibility, diagnostic value, and safety of pericardioscopy for pericardial effusion.
- To explore technical modifications, such as air instillation, to optimize the procedure.
Main Methods:
- Pericardioscopy was performed using a flexible endoscope in 32 patients with pericardial effusions.
- Subxiphoid pericardiocentesis and drainage preceded the endoscopic procedure.
- Aimed pericardial biopsies were obtained using specialized forceps, with standard or extensive sampling.
Main Results:
- Endoscopic visualization was superior with air instillation compared to saline.
- Pericardioscopy significantly improved the diagnostic value and sampling efficiency of pericardial biopsies compared to fluoroscopy-guided biopsy alone.
- Sampling efficiency was 86.2% (standard) and 87.3% (extensive) with pericardioscopy versus 43.7% with fluoroscopy alone.
- No major complications were observed; minor complications included transient ventricular tachycardia and pain at the sheath entry site.
Conclusions:
- Pericardioscopy, especially with air instillation, is a safe and technically feasible procedure for diagnosing pericardial diseases.
- The technique offers excellent visualization and extensive pericardial sampling, enhancing the diagnostic accuracy of biopsies.
- It represents a valuable advancement in the evaluation of pericardial effusions and diseases.