Related Experiment Videos
Catheter drainage of the pericardium. Practical method to maintain long-term patency
A K Patel1, P K Kosolcharoen, M Nallasivan
1Wm. Middleton Memorial Veterans Hospital, Madison, WI 53705.
Insights
Continuous heparinized saline flushes prevent blockage in indwelling pericardial catheters used for large pericardial effusions and cardiac tamponade, ensuring safe, reliable drainage for up to seven days.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Pericardiocentesis with indwelling catheters is standard for large pericardial effusions and cardiac tamponade.
- Catheter blockage and infection are significant complications of indwelling pericardial drainage systems.
Purpose of the Study:
- To describe a technique for maintaining patency of indwelling pericardial drainage catheters.
- To present practical aspects of using a continuous flush system for pericardial catheter management.
Main Methods:
- Utilized slow infusion of heparinized saline solution (3 ml/hr) via a continuous flush device.
- Monitored catheter patency in 16 patients with pericardial effusions secondary to malignancy, uremia, and cardiac surgery.
Main Results:
- Successfully maintained catheter patency for up to seven days (mean 3.6 days) in all 16 patients.
- The continuous flush technique effectively prevented catheter blockage.
Conclusions:
- Continuous heparinized saline infusion is a practical and effective method to maintain indwelling pericardial catheter patency.
- Pericardiocentesis with catheter drainage is a successful treatment for most pericardial effusions when drainage is reliable.
- Surgical interventions are reserved for complex cases like loculated effusions or significant recurrences.
Abstract:
Pericardiocentesis with catheter insertion and drainage is widely used in management of large pericardial effusions and cardiac tamponade. Two potential problems with an indwelling pericardial catheter system are catheter blockage and infection. We have utilized slow infusion of heparinized saline solution (3 ml/hr) via a continuous flush device to maintain catheter patency for up to seven days (mean 3.6) in 16 patients. Pericardial effusions were secondary to malignancy, uremia, and cardiac surgery. This article describes practical aspects of the technique. Most pericardial effusions can be successfully treated with pericardiocentesis and catheter drainage, provided the drainage is continued reliably and safely for several days. Surgical treatment such as subxiphoid pericardiostomy or partial pericardiectomy should be reserved for loculated effusions, clotted blood, subacute effusive-constrictive pericarditis, or significant recurrences after initial drainage.