Kardiyak tamponad acil müdahale
gerektiren, hayatı tehdit eden bir hastalıktır. Biriken sıvı cerrahi ya da
perkütan yol ile boşaltılabilir. Perikardiyal efüzyonun perkütan yol ile
boşaltılması, miyokardiyal ve koroner laserasyon, perforasyon, hava embolisi,
pnömotoraks, aritmi, periton yaralanması, abdominal organ hasarı, internal
mamariyen arter fistülizasyonu, akut pulmoner ödem ve pürülan perikardit riski
taşır. Biz bu yazıda perikardiyosentez için kolay ve güvenli bir metod olarak,
perikardiyal boşluğa kateter ve klavuz tel yerleştirmeden önce Seldinger
iğnesinden kontrast amaçlı ajite serum uygulanan bir olguyu sunuyoruz. Basit,
rahat ve kolay uygulanabilir bir yöntem olması nedeniyle kateter ve kılavuz
telin perikardiyal boşluğa yerleştirilmesinden önce uygulan ajite serum
kontrast ile bu istenmeyen komplikasyonların önüne geçilebilir.
1. Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y, et al; Task Force on the Diagnosis and Management of Pricardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases executive summary; the task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J 2004;25:587-610.
2. Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc
2002;77:429-36.
3. Maisch B, Ristic AD. Tangential approach to small pericardial effusions under fluoroscopic guidance in the lateral view: the halo phenomenon. Circulation 2001;103(Suppl A):730.
4. Tsang TS, Barnes ME, Hayes SN, Freeman WK, Dearani JA, Butler SL, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic Experience 1979-1998. Chest 1999;116:322-31.
Cardiac tamponade is a
life-threatening condition requiring urgent intervention. It may either be
drained surgically or percutaneously. Percutaneous drainage of pericardial
effusion bears the risk of laceration and perforation of the myocardium and the
coronary vessels, air embolism, pneumothorax, dysrhythmias, puncture of the
peritoneal cavity and abdominal viscera, internal mammary artery fistula, acute
pulmonary edema, and purulent pericarditis. Here, we report an easy and safe
approach for pericardiocentesis under the guidance of agitated saline contrast
injection through a Seldinger needle before inserting guidewire and catheter.
This cheap, easy, feasible, and comfortable method of injection of agitated
saline contrast before the insertion of guidewire and catheter may prevent the
undesired complications.
1. Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y, et al; Task Force on the Diagnosis and Management of Pricardial Diseases of the European Society of Cardiology. Guidelines on the diagnosis and management of pericardial diseases executive summary; the task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J 2004;25:587-610.
2. Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc
2002;77:429-36.
3. Maisch B, Ristic AD. Tangential approach to small pericardial effusions under fluoroscopic guidance in the lateral view: the halo phenomenon. Circulation 2001;103(Suppl A):730.
4. Tsang TS, Barnes ME, Hayes SN, Freeman WK, Dearani JA, Butler SL, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management: Mayo Clinic Experience 1979-1998. Chest 1999;116:322-31.
Aykan AÇ, Karabay CY, Zehir R, Şahin Yıldız B. Therapeutic Pericardiocentesis Under the Guidance of Transthoracic Echocardiography with the Use of Agitated Saline Contrast. Koşuyolu Heart Journal. 2016;19(1):42-3.