BibTex RIS Kaynak Göster

Effectiveness of Subxiphoid Percutaneous Catheter Drainage in Management of Pericardial Effusions

Yıl 2014, Cilt: 4 Sayı: 3, 129 - 134, 01.09.2014
https://doi.org/10.5505/sakaryamj.2014.42204

Öz

Objective: Pericardial effusion is a common finding in everyday practice and causes of pericardial effusion requiring pericardiocentesis are very complex. We aimed to investigate the most common etiology of large pericardial effusions and diagnostic value of pericardiocentesis through a needle between our patients who underwent fluoroscopy guided pericardiocentesis because of large pericardial effusion or tamponade.Materials and methods: Medical records of patients between June 2008- January 2010 were evaluated retrospectively.Results: Mean age was 54.9± 16.7 years, and 42 (59.2%) of patients were female. Most common presenting symptom was dispnea (94.3%). Echocardiographic analysis showed tamponade in 58 patients (81.6%). Lung malignancy was the most common malignancy (15 patients). The average drainage period was 1.7± 1.0 day, and total drainage volume was 1297 ± 474 ml. The fluid was hemorrhagic in 31 (43.6%) patients. Histopathological examination of the pericardial fluid was positive for malignant cells in 8 (25.8%) of the 31 patient. Acute inflammatory cells were seen in 8 pericardial fluid samples. Microbiologic cultures identified the microorganisms in 4 cases. Periprocedural complications were seen in 2 patients. Recurrence was seen in 8 (11.2%) patients within 30 days, and all of these 8 patients had malignancy. Conclusion: Malignancy is the most common cause of pericardial effusion requiring pericardiocentesis drainage in our hospital. Short drainage periods and underlying malignancy is associated with recurrence.

Kaynakça

  • Sagrista-Sauleda J, Merce J, Permanyer- Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med 2000; 109: 95-101.
  • Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine 2003; 82: 385-391.
  • Maisch B, Ristic AD. Practical aspects of the management of pericardial disease. Heart 2003; 89: 1096–1103.
  • Buchanan CL, Sullivan VV, Lampman R, Kulkarni MG. Pericardiocentesis with extended catheter drainage: an effective therapy. Ann Thorac Surg 2003; 76: 817–820.
  • Barrio LG, Morales JH, Delgado C, Benito A, Larrache J, Martinez-Cuesta A, et al. Percutaneous balloon pericardial window for patients with symptomatic pericardial effusion. Cardiovasc Intervent Radiol 2002; 25: 360–364.
  • 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: 429-436.
  • Vaitkus PT, Herrmann HC, LeWinter MM. Treatment of malignant pericardial effusion. JAMA 1994; 272: 59-64.
  • Meyers DG, Meyers RE, Prendergast TW. The usefulness of diagnostic tests on pericardial fluid. Chest 1997; 111: 1213-1221.
  • Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y, et al. Guidelines on the diagnosis and management of pericardial diseases. Eur Heart J 2004; 25: 587–610.
  • Burstow DJ, Oh JK, Bailey KR, Seward JB, Tajik AJ. Cardiac tamponade characteristic Doppler observations. Mayo Clin Proc 1989; 64: 312.
  • N Becit, Y Unlu, M Ceviz, C U Kocogullari, H Kocak, Y Gurlertop. Subxiphoid pericardiostomy in the management of pericardial effusions: case series analysis of 368 patients. Heart 2005; 91: 785–790.
  • Gornik HL, Gerhard-Herman M, Beckman JA. Abnormal cytology predicts poor prognosis in cancer patients with pericardial effusion. J Clin Oncol 2005; 23: 5211–5216.
  • Ma W, Liu J, Zeng Y, Chen S, Zheng Y, Ye S, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz 2012; 37:183-187.
  • Thummler F, Schmidt H, Evequoz D. Pericardial effusion in the hospital diagnosis and therapy. Schweiz Rundsch Med Prax 1999; 23: 1573–1580.
  • Lindenberger M, Kjellberg M, Karlsson E, Wranne B. Pericardiocentesis guided by 2-D echocardiography: the method of choice for treatment of pericardial effusion. J Intern Med 2003; 253: 411–417.
  • Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB.Outcomes of clinically significant idiopathic pericardial effusion requiring intervention. Am J Cardiol 2002; 91: 704–707.
  • Soler-Soler J, Sagristà-Sauleda J, Permanyer-Miralda G. Management of pericardial effusion. Heart 2001; 86: 235-240.
  • Wiener HG, Kristensen IB, Haubek A, Kristensen B, Baandrup U. The diagnostic value of pericardial cytology: An analysis of 95 cases. Acta Cytol 1991; 35: 149-153.
  • Edoute Y, Malberger E, Kuten A, Ben-Haim SA, Moscovitz M. Cytologic analysis of pericardial effusion complicating extracardiac malignancy. Am J Cardiol 1992; 69: 568-571.
  • Corey GR, Campbell PT, Van Trigt P, Kenney RT, O'Connor CM, Sheikh KH, et al. Etiology of large pericardial effusions. Am J Med 1993; 95: 209-213.
  • Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore) 2003; 82: 385- 391.

Perikart Efüzyonu Yönetiminde Subksifoid Perkütan Kateter Drenaj Etkinliği

Yıl 2014, Cilt: 4 Sayı: 3, 129 - 134, 01.09.2014
https://doi.org/10.5505/sakaryamj.2014.42204

Öz

Amaç: Perikart efüzyonu sıkça karşılaşılabilen bir durumdur ve perikardiyosentez gerektiren perikart efüzyonlarının nedenleri çok değişkendir. Bu çalışmada klinik uygulamada sıkça tercih edilen geleneksel yöntemle floroskopi eşliğinde perikart sıvısı boşaltılan hastalardaki en sık etiyolojiyi ve işlemin tanısal değerinin yeterliliğinin araştırılması amaçlanmıştır. Gereç ve yöntemler: Haziran 2008 ve Ocak 2010 tarihleri arasında kliniğimize başvuran hastaların tıbbi kayıtları geriye dönük olarak incelendi.Bulgular: Hastaların ortalama yaşı 54.9± 16.7 yıldı ve hastaların 42' si bayandı (%59.2). En sık ilk başvuru şikayeti solunum güçlüğüydü (%94.3). Ekokardiyografide 58 hastada (%81.6) tamponad saptandı. Akciğer kanseri en sık saptanan kanser türüydü (15 hasta). Ortalama boşaltma süresi 1.7± 1.0 gün, toplam boşaltılan sıvı hacmi 1297 ± 474 ml idi. Hastaların %43,6' sında boşaltılan sıvı kanlı vasıftaydı. Histopatolojik incelemede sadece 8 hastada (%25.8) kanser hücreleri gösterilebildi. Sekiz hastanın ise perikart sıvı örneklerinde iltihabi hücreler saptandı. Sıvı örneklerinden yapılan ekimlerde 4 vakada mikroorganizma üremesi mevcuttu. İki hastada işleme bağlı komplikasyon görüldü. İlk 30 günde 8 hastada (%11.2) yineleyen sıvı toplanması oldu ve bu hastaların hepsi kanser hastalarıydı.Sonuç: Hastalarımız arasında boşaltım gerektiren perikart efüzyonunun en sık etyolojik nedeni kanserdi. Kısa boşaltma süreleri ve altta yatan kanser yineleme ile ilişkili bulunmuştur.

Kaynakça

  • Sagrista-Sauleda J, Merce J, Permanyer- Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med 2000; 109: 95-101.
  • Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine 2003; 82: 385-391.
  • Maisch B, Ristic AD. Practical aspects of the management of pericardial disease. Heart 2003; 89: 1096–1103.
  • Buchanan CL, Sullivan VV, Lampman R, Kulkarni MG. Pericardiocentesis with extended catheter drainage: an effective therapy. Ann Thorac Surg 2003; 76: 817–820.
  • Barrio LG, Morales JH, Delgado C, Benito A, Larrache J, Martinez-Cuesta A, et al. Percutaneous balloon pericardial window for patients with symptomatic pericardial effusion. Cardiovasc Intervent Radiol 2002; 25: 360–364.
  • 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: 429-436.
  • Vaitkus PT, Herrmann HC, LeWinter MM. Treatment of malignant pericardial effusion. JAMA 1994; 272: 59-64.
  • Meyers DG, Meyers RE, Prendergast TW. The usefulness of diagnostic tests on pericardial fluid. Chest 1997; 111: 1213-1221.
  • Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y, et al. Guidelines on the diagnosis and management of pericardial diseases. Eur Heart J 2004; 25: 587–610.
  • Burstow DJ, Oh JK, Bailey KR, Seward JB, Tajik AJ. Cardiac tamponade characteristic Doppler observations. Mayo Clin Proc 1989; 64: 312.
  • N Becit, Y Unlu, M Ceviz, C U Kocogullari, H Kocak, Y Gurlertop. Subxiphoid pericardiostomy in the management of pericardial effusions: case series analysis of 368 patients. Heart 2005; 91: 785–790.
  • Gornik HL, Gerhard-Herman M, Beckman JA. Abnormal cytology predicts poor prognosis in cancer patients with pericardial effusion. J Clin Oncol 2005; 23: 5211–5216.
  • Ma W, Liu J, Zeng Y, Chen S, Zheng Y, Ye S, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz 2012; 37:183-187.
  • Thummler F, Schmidt H, Evequoz D. Pericardial effusion in the hospital diagnosis and therapy. Schweiz Rundsch Med Prax 1999; 23: 1573–1580.
  • Lindenberger M, Kjellberg M, Karlsson E, Wranne B. Pericardiocentesis guided by 2-D echocardiography: the method of choice for treatment of pericardial effusion. J Intern Med 2003; 253: 411–417.
  • Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB.Outcomes of clinically significant idiopathic pericardial effusion requiring intervention. Am J Cardiol 2002; 91: 704–707.
  • Soler-Soler J, Sagristà-Sauleda J, Permanyer-Miralda G. Management of pericardial effusion. Heart 2001; 86: 235-240.
  • Wiener HG, Kristensen IB, Haubek A, Kristensen B, Baandrup U. The diagnostic value of pericardial cytology: An analysis of 95 cases. Acta Cytol 1991; 35: 149-153.
  • Edoute Y, Malberger E, Kuten A, Ben-Haim SA, Moscovitz M. Cytologic analysis of pericardial effusion complicating extracardiac malignancy. Am J Cardiol 1992; 69: 568-571.
  • Corey GR, Campbell PT, Van Trigt P, Kenney RT, O'Connor CM, Sheikh KH, et al. Etiology of large pericardial effusions. Am J Med 1993; 95: 209-213.
  • Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore) 2003; 82: 385- 391.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Emir Karaçağlar Bu kişi benim

Tansel Erol Bu kişi benim

Selçuk Baysal Bu kişi benim

Hafize Corut Bu kişi benim

İlyas Atar Bu kişi benim

Haldun Müderrisoğlu Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2014
Gönderilme Tarihi 7 Eylül 2015
Yayımlandığı Sayı Yıl 2014 Cilt: 4 Sayı: 3

Kaynak Göster

AMA Karaçağlar E, Erol T, Baysal S, Corut H, Atar İ, Müderrisoğlu H. Perikart Efüzyonu Yönetiminde Subksifoid Perkütan Kateter Drenaj Etkinliği. Sakarya Tıp Dergisi. Eylül 2014;4(3):129-134. doi:10.5505/sakaryamj.2014.42204

30703

SMJ'de yayınlanan makaleler, Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı kapsamında lisanslanır