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Updated: Jun 10, 2026
Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
[Pericardiocentesis and drainage]
1Department of Cardiovascular Surgery, Yokohama Rosai Hospital, Yokohama, Japan.
Insights
Pericardial effusion diagnosis and treatment involve pericardiocentesis or pericardiotomy. Ultrasonically-guided puncture and drainage tubes offer safer, effective management for pericardial effusions, minimizing myocardial injury.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Imaging
Context:
- Pericardial effusion, an accumulation of fluid around the heart, requires timely diagnosis and intervention.
- Conventional treatments include blind puncture and surgical pericardiotomy.
- Managing effusions, especially those unevenly distributed, presents challenges in preventing cardiac injury.
Purpose:
- To review diagnostic and therapeutic strategies for pericardial effusion.
- To highlight the benefits of ultrasonically-guided pericardiocentesis.
- To discuss surgical approaches and adjunctive drainage techniques.
Summary:
- Pericardiocentesis, particularly when guided by ultrasound, offers a safer alternative to blind puncture for treating pericardial effusion, even in challenging cases.
- Surgical pericardiotomy via various approaches (parasternal, subxiphoid, lateral-thoracic) is an option, with video-assisted procedures offering a less-invasive alternative to lateral thoracotomy.
- Coaxial introduction of drainage tubes facilitates the management of persistent or infectious pericardial effusions, aiding in pathogenesis analysis and purulent substance evacuation.
Impact:
- Improved patient outcomes through minimally invasive and guided procedures.
- Reduced risk of iatrogenic myocardial injury during effusion drainage.
- Enhanced management of complex and infectious pericardial effusion cases.
Abstract:
Diagnosis and treatment of pericardial effusion need to be performed frequently by pericardiocentesis or surgical pericardiotomy. Large retention of the effusion is treated conventionally by percutaneous blind puncture, while possible injuries to the myocardium are avoided feasibly by ultrasonically-guided puncture even in case that the effusion remains moderately or unevenly inside the pericardial space. Along with the puncture, drainage tube introduced into the pericardial sac using coaxial method contributes to relieving coexistent pericardial or chronic exudation. The pericardium is also surgically approached traditionally via parasternal, subxiphoid, or lateral-thoracic route. Specimen of the pericardium is optionally sampled to promote analyzing the pathogenesis, and drainage tubes of larger diameter facilitate evacuating the purulent substance in the settings of infectious origins. The lateral thoracotomy is occasionally applied to the effusion around the posterior aspect of the heart, which is preferably replaced by less-invasive video-assisted procedure. Those several measures would facilitate the treatment for pericardial effusion.
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