scholarly journals A Novel Ultrasound-guided With Needle Visualization Pericardiocentesis Via Subcostal Approach

2021 ◽  
Author(s):  
Osman Adi ◽  
Nurul Shaliza Shamsudin ◽  
Chan Pei Fong ◽  
Muhammad Faiz Baherin ◽  
Azma Haryaty Ahmad
Keyword(s):  
Cardiac Tamponade ◽  
High Frequency ◽  
Technology Development ◽  
Surgical Techniques ◽  
Pericardial Fluid ◽  
Ultrasound Guided ◽  
Hemodynamic Status ◽  
Hemodynamic Compromise ◽  
Plane Technique ◽  
Needle Trajectory

Abstract Cardiac tamponade is a condition when fluids or blood fill the pericardial space resulting in compression of the heart and subsequently compromising hemodynamic status of the patient. It is a potentially fatal medical or traumatic emergency that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used to aspirate the pericardial fluid and they were associated with plenty of risks and complications. In the recent era, medical technology development has enabled us to perform the procedure safely with the assistance of ultrasound devices. The ultrasound-guided procedure is not only proven to be effective and safe, but it also has very minimal drawbacks and complications. In the literature, there are many ultrasound-guided pericardiocentesis procedures performed with different approaches at different regions. They include subcostal, parasternal, and para-apical approaches and phased array echocardiography transducers are typically preferred for the procedures. We report a case of cardiac tamponade presented with hemodynamic compromise. Ultrasound-guided pericardiocentesis was carried out using in-plane technique with high frequency linear ultrasound transducer at the subcostal region as lifesaving procedure. This particular technique provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient’s hemodynamic status improved post-procedure. This article highlights the novel use of in-plane method with high frequency linear transducer at subcostal area as a safe option for pericardiocentesis in patients with cardiac tamponade.

scholarly journals A Window in the Heart Is Sometimes a Good Start: It’s Not Always Sepsis

2021 ◽  
Author(s):  
Subrat Khanal ◽  
◽  
Hassan Al-Khalisy ◽  
Keyword(s):  
Cardiac Tamponade ◽  
Clinical Diagnosis ◽  
Pericardial Fluid ◽  
Transmural Pressure ◽  
Critical Levels ◽  
Fluid Accumulation ◽  
Compensatory Mechanisms ◽  
Hemodynamic Compromise ◽  
Abnormal Accumulation ◽  
Life Threatening

Cardiac tamponade is a life-threatening compression of the heart caused by abnormal accumulation of pericardial fluid. Important elements affecting its disposition and treatment are the rate of fluid accumulation relative to pericardial stretch and the effectiveness of compensatory mechanisms before critical hemodynamic compromise occurs. It is a clinical diagnosis and waiting for the threshold of steep rise in cardiac transmural pressure to critical levels may lead to catastrophic outcomes which is why early drainage has to be strongly considered in suspected cases.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Final Diagnosis ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion ◽  
Typical Cell ◽  
High Fluorescence ◽  
Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

2021 ◽  
pp. 155335062199779
Author(s):  
Difu Fan ◽  
Leming Song ◽  
Monong Li ◽  
Chunxiang Luo ◽  
Xiaohui Liao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Real Time ◽  
Clinical Application ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Plane Group ◽  
Plane Technique ◽  
Guided Puncture

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

Efficacy of High-Frequency Jet Ventilation in Cardiac Tamponade

1990 ◽  
Vol 70 (4) ◽  
pp. 375???381 ◽  
Author(s):  
Keiji Goto ◽  
Hiroshi Goto ◽  
Kirk T. Benson ◽  
Gregory K. Unruh ◽  
Kasumi Arakawa
Keyword(s):  
Cardiac Tamponade ◽  
High Frequency ◽  
Jet Ventilation ◽  
High Frequency Jet Ventilation

scholarly journals Management of Cardiac Tamponade: A Comperative Study between Echo-Guided Pericardiocentesis and Surgery—A Report of 100 Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Hasan Ali Gumrukcuoglu ◽  
Dolunay Odabasi ◽  
Serkan Akdag ◽  
Hasan Ekim
Keyword(s):  
Surgical Treatment ◽  
Cardiac Tamponade ◽  
Total Mortality ◽  
Invasive Procedure ◽  
Mortality Rates ◽  
Pericardial Fluid ◽  
Complication Rates ◽  
Optimal Method ◽  
First Choice ◽  
Group A

Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes.Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and follow-up data were collected.Results. Echo-guided pericardiocentesis was performed in 38 (38%) patients (Group A), primary surgical treatment was preformed in 36 (36%) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26%) patients (Group C). Idiopathic and malignant diseases were primary cause of tamponade (28% and 28%, resp.), followed by tuberculosis (14%). Total complication rates, 30-day mortality, and total mortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A.Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates.

Graves’ disease inducing a massive cardiac tamponade

2021 ◽  
Vol 14 (3) ◽  
pp. e239772
Author(s):  
Elisabeth Martinez Fonseca ◽  
Igor Schonhofen ◽  
Maria Pereira Toralles ◽  
Jozelio Freire de Carvalho
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Nyha Class ◽  
Clinical Manifestations ◽  
Emergency Admission ◽  
Heart Association ◽  
Pericardial Fluid ◽  
Graves Disease ◽  
Class Iii ◽  
Filling Time

A 23-year-old woman was diagnosed with Graves’ disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She developed progressive respiratory dyspnoea [New York Heart Association (NYHA) class III] and frequent palpitations. On emergency admission, the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats per minute), with an oxygen saturation of 94%. She also presented with cold, swollen and shaky extremities, with extended capillary filling time, and a significant reduction in heart sounds. Echocardiogram showed massive pericardial effusion compatible with cardiac tamponade. Pericardiocentesis was performed, with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of pericardial effusion secondary to Graves’ disease was determined and corticotherapy, lithium carbonate, cholestyramine and phenobarbital were prescribed. An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.

scholarly journals Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA) of the Pancreas in a Porcine Model

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Monica Gaidhane ◽  
Ioana Smith ◽  
Kristi Ellen ◽  
Jeremy Gatesman ◽  
Nagy Habib ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
High Frequency ◽  
Porcine Model ◽  
Tissue Injury ◽  
Pancreatic Head ◽  
Minimal Amount ◽  
Coagulative Necrosis ◽  
Ultrasound Guided ◽  
Distal Pancreas ◽  
Minimal Evidence

Backgrounds. Limited effective palliative treatments exist for pancreatic cancer which includes surgery or chemotherapy. Radiofrequency ablation (RFA) uses high frequency alternating current to ablate diseased tissue and has been used to treat various tumors. In this study, we evaluated a prototype probe adjusted to the EUS-needle to perform EUS-RFA to permit coagulative necrosis in the pancreas.Methods. Five Yucatan pigs underwent EUS-guided radiofrequency ablation of the head of their pancreas. Using an EUS-needle, RFA was applied with 6 mm and then 10 mm of the probe exposed at specific wattage for preset durations.Results. Only one pig showed moderate levels of pancreatitis (20% proximal pancreatitis). The other animals showed much lower areas of tissue damage. In 3 of the 5 pigs, the proximal pancreas showed greater levels of tissue injury than the distal pancreas, consistent with the proximity of the tissue to the procedure site. In 1 pig, both proximal and distal pancreas showed minimal pancreatitis (1%). There was minimal evidence of fat necrosis in intra-pancreatic and/or extra-pancreatic adipose tissue.Conclusion. EUS-guided RFA of the pancreatic head with the monopolar probe through a 19-gauge needle was well tolerated in 5 Yucatan pigs and with minimal amount of pancreatitis.

scholarly journals SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade

2020 ◽  
Vol 76 ◽  
pp. 100-101 ◽  
Author(s):  
Andrea Farina ◽  
Giuseppe Uccello ◽  
Marta Spreafico ◽  
Giorgio Bassanelli ◽  
Stefano Savonitto
Keyword(s):  
Cardiac Tamponade ◽  
Pericardial Fluid

Dying from haemorrhagic cardiac tamponade – a case series

2019 ◽  
Vol 87 (4) ◽  
pp. 210-214
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Tamponade ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Case Series ◽  
Dissecting Aneurysm ◽  
Pericardial Fluid ◽  
Naturally Occurring ◽  
Great Vessels ◽  
Myocardial Abscess

Cardiac tamponade is a condition produced by the rapid accumulation of pericardial fluid, which restricts the filling of the heart. Often the forensic pathologist comes across different naturally occurring sudden deaths. Cardiovascular causes are the most common. Death due to cardiac tamponade can cause sudden cardiac death. Acute cardiac tamponade is almost invariably fatal, unless the pressure is relieved by removing the pericardial fluid, either by needle pericardiocentesis or surgical procedures. Cardiac tamponade is more commonly associated with cases of trauma, operative procedures, secondary to myocardial infarction or intra pericardial rupture of great vessels. Previous literature showed an association of cardiac tamponade with many other pathological conditions such as malignancy, central venous catheterisation, open heart surgery, dissecting aneurysm of the aorta, myocardial abscess, infective endocarditis, etc. We report a series of three cases where cardiac tamponade was given as the cause of death on autopsy secondary to post-myocardial infarction wall rupture.

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