[Pericardiac puncture. The most favorable anatomical approach (author's transl)]

On the basis of pericardiac punctures in 105 prepared patients and of pericardiac preparation in 92 adults, a simple low-risk method of epigastric pericardiac puncture is described. The needle is pushed at 33 degrees to the front level in about 1/2 cm below the left costoxiphoid angle and directed towards the right acromion. At a depth of about 4.5 cm the needle penetrates the pericardium. The left internal thoracic artery, the pericardial vessels, the arteria marginalis dextra and the anterior interventricular artery are usually more than 2 cm distant from the needle. When the pericardial infusion is small, the tip of the needle may come relatively close to the right coronary artery (1.3 +/- 1 cm).