Hsu Li-Fern, Scavée Chroistophe, Jaïs Pierre, Hocini Mélèze, Haïssaguerre Michel
Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
J Cardiovasc Electrophysiol. 2003 Sep;14(9):1001-3. doi: 10.1046/j.1540-8167.2003.03153.x.
Life-threatening cardiac tamponade is one of the most serious complications of catheter-based cardiac procedures. Although most cases can be effectively treated by percutaneous pericardiocentesis, urgent surgical drainage is required in unsuccessful cases. Rarely, in collapsed patients, the delay for surgery, however minimal, may be fatal. We describe a technique whereby life-saving pericardial drainage was rapidly achieved via a novel transcardiac approach, using the transseptal puncture kit, after failure of conventional pericardiocentesis in a patient with procedure-related acute tamponade who rapidly deteriorated and developed cardiorespiratory arrest within a few minutes. Although surgical repair for the perforation had to be performed subsequently, the patient survived without sequelae. This transcardiac approach may be an important and potentially life-saving adjunctive technique after failure of conventional pericardiocentesis in rapidly deteriorating or extremely unstable patients.
危及生命的心包填塞是基于导管的心脏手术最严重的并发症之一。尽管大多数病例可通过经皮心包穿刺有效治疗，但治疗失败的病例需要紧急手术引流。在极少数情况下，对于病情严重的患者，手术延迟（无论多么短暂）都可能是致命的。我们描述了一种技术，在一名因手术相关急性心包填塞而迅速恶化并在几分钟内发生心肺骤停的患者中，传统心包穿刺失败后，通过一种新颖的经心脏途径，使用经房间隔穿刺套件，迅速实现了挽救生命的心包引流。尽管随后不得不进行穿孔的手术修复，但患者存活且无后遗症。这种经心脏途径可能是传统心包穿刺失败后，在迅速恶化或极度不稳定患者中一种重要且可能挽救生命的辅助技术。
