Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-17T14:02:07.919Z Has data issue: false hasContentIssue false

Pericardial effusions in infants and children: injection of echo contrast medium enhances the safety of echocardiographically-guided pericardiocentesis

Published online by Cambridge University Press:  19 August 2008

Eberhard Georg Mühler*
Affiliation:
Klinikfür Kinderkardiologie, Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule Aachen, Aachen, Germany
Wolfgang Engelhardt
Affiliation:
Klinikfür Kinderkardiologie, Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule Aachen, Aachen, Germany
Götz von Bernuth
Affiliation:
Klinikfür Kinderkardiologie, Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule Aachen, Aachen, Germany
*
PD Dr. E. G. Mühler, Klinik für Kinderkardiologie, Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule Aachen, Pauwelsstr. 30, D - 52057 Aachen, Germany. Tel: 49 241 8088981; Fax: 49 241 8888450

Abstract

Pericardiocentesis is usually an easy and uncomplicated procedure when guided by cross-sectional echocardiography, but an abnormal intracardiac or extrapericardial position of the puncture system can occur, especially in children. Injection of echo contrast medium through the puncture needle is a very sensitive, quick, easy and harmless procedure which can be performed at the bedside in all cases in which doubt remains concerning the location of the needle. Prompt enhancement of signal intensity of the peri-cardial fluid validates the correct intrapericardial position, and permits visualization of the tip of the needle. Absence of echodense formations excludes an intrapericardial position. We recommend the use of echo contrast medium during pericardiocentesis whenever blood is aspirated through the needle, or if there is any doubt concerning its location.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Callahan, JA, Seward, JB, Tajik, AJ, Holmes, DR Jr; Smith, HC, Reeder, GS, Miller, FA Jr. Pericardiocentesis assisted by two-dimensionalechocardiography. J Thorac Cardiovasc Surg 1983; 85: 877879.CrossRefGoogle Scholar
2.Callahan, JA, Seward, JB, Nishimura, RA, Miller, FA Jr, Reeder, GS, Shub, C, Callahan, MJ, Schattenberg, TT, Tajik, AJ. Two- dimensional echocardiographically guided pericardiocentesis: experience in 117 consecutive patients. Am J Cardiol 1985; 55:476479.Google Scholar
3.Little, AG, Kremser, PC, Wade, JL, Levett, JM, DeMeester, TR, Skinner, DB. Operation for diagnosis and treatment of pericar-dial effusions. Surgery 1984; 96: 738744.Google Scholar
4.Suehiro, S; Hattori, K; Shibata, T; Sasaki, Y; Minamimura, H; Kinoshita, H. Echocardiography-guidedpericardiocentesis with a needle attached to a probe. Ann Thorac Surg 1996; 61: 741742.CrossRefGoogle ScholarPubMed
5.Yilmaz, AT, Arslan, M, Demirklic, U, Kuralay, E, Ozal, E, Bingol H, Oz BS, Tatar H, Ozturk OY Late posterior cardiac tam-ponade after open heart surgery. J Cardiovasc Surg Torino 1996; 37:615620.Google ScholarPubMed
6.Sandring, KH; Muller, C. CT-guided percutaneous puncture and drainage of pericardial effusion. Radiol Diagn Berl 1989; 30: 643646.Google Scholar
7.Duvernoy, O, Magnusson, A. CT-guided pericardiocentesis. Acta Radiol. 1996; 37: 775778.Google Scholar
8.Chandraratna, PAN, Reid, CL, Nimalasuriya, A, Kawanishi, D, Rahimtoola, SH. Application of 2-dimensional contrast studies during pericardiocentesis. Am J Cardiol 1983; 52: 11201122.CrossRefGoogle ScholarPubMed
9.Mostbeck, GH, Korn, M, Wittich, GR, Walter, RM, Gebauer, A, Schurawitzki, H, Tscholakoff, D. The percutaneous ultrasonic-guided fluoroscopy-controlled drainage of pericardial fluids. Fortschr Rontgenstr 1991; 155: 5357.Google Scholar