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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Anatomic Approach and Outcomes in Children Undergoing Percutaneous Pericardiocentesis.

Faith Myers1, Varun Aggarwal1, John L Bass1

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Masonic Children's Hospital, University of Minnesota, 2450 Riverside Ave, East Building Room MB547, Minneapolis, MN, 55454, USA.

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Summary

This study compared subxiphoid and non-subxiphoid approaches for pediatric pericardiocentesis. Echocardiography-guided non-subxiphoid pericardiocentesis in children is safe and effective, with shorter procedure times and similar complication rates.

Keywords:
Non-subxiphoid approachPericardial effusionPericardiocentesis

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Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Medical Procedures

Background:

  • Pericardiocentesis is a procedure to drain fluid from the pericardium.
  • Traditionally, the subxiphoid approach is used.
  • Non-subxiphoid approaches are becoming feasible with echocardiographic guidance, especially for complex effusions.

Purpose of the Study:

  • To compare clinical outcomes of subxiphoid versus non-subxiphoid approaches for percutaneous pericardiocentesis in pediatric patients.
  • To evaluate the safety and efficacy of different pericardiocentesis techniques in children.

Main Methods:

  • Retrospective chart review of 104 pediatric patients undergoing echocardiography-guided pericardiocentesis from August 2008 to December 2019.
  • Comparison of clinical outcomes between subxiphoid and non-subxiphoid approaches.
  • Analysis of procedure times, complication rates, and patient demographics.

Main Results:

  • A non-subxiphoid approach was used in 58.6% of patients.
  • The non-subxiphoid group was older and weighed more than the subxiphoid group.
  • Non-subxiphoid pericardiocentesis was associated with significantly shorter procedure times (21 vs. 37 minutes).
  • No major complications occurred; minor complications were equally distributed and more likely in younger patients.
  • Technique, approach, or effusion characteristics did not influence complication risk.

Conclusions:

  • Echocardiography-guided percutaneous pericardiocentesis in children is associated with low complication rates.
  • The non-subxiphoid approach is a safe and effective alternative to the subxiphoid approach.
  • Non-subxiphoid pericardiocentesis offers the advantage of shorter procedure times in pediatric patients.