Penetrating Cardiac Injury Into Ascending Aorta During Thoracocentesis.

Area of Science:

• Medical procedures
• Thoracic surgery
• Cardiology

Background:

• Pneumothorax is a common condition requiring intervention.
• Thoracocentesis is a standard procedure for treating pneumothorax.
• Fluoroscopic guidance is often used to improve accuracy during needle insertion.

Purpose of the Study:

• To evaluate the risk of cardiac injury during thoracentesis for pneumothorax.
• To determine the optimal intercostal space for needle insertion to minimize cardiac risk.

Main Methods:

• Retrospective analysis of thoracentesis procedures.
• Review of imaging data to assess needle trajectory and proximity to cardiac structures.
• Comparison of outcomes based on intercostal space selection.

Main Results:

• Thoracentesis, even with fluoroscopy, carries a risk of penetrating cardiac injury.
• Needle insertion at the 5th intercostal space is associated with a higher risk of cardiac injury compared to the 2nd intercostal space.
• The 5th intercostal space is anatomically closer to the cardiac apex.

Conclusions:

• The 2nd intercostal space is the preferred site for needle insertion during thoracentesis for pneumothorax.
• Careful anatomical consideration is essential to prevent iatrogenic cardiac injury during thoracic procedures.