Güler Ekrem, Babur Güler Gamze, Demir Gültekin G, Kızılırmak Filiz
Department of Cardiology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey.
Turk Kardiyol Dern Ars. 2015 Sep;43(6):565-7. doi: 10.5543/tkda.2015.49060.
Pericardiocentesis is a life-saving procedure performed in cardiac tamponade cases occurring in infective, inflammatory or malignancy conditions, or following percutaneous coronary intervention, cardiac device implantation or catheter ablation. In spite of advanced imaging methods, a substantial risk of complication persists. Emergent surgical intervention may be required, in particular during advancement of the catheter into the heart chambers or in cases of wall rupture. Furthermore, in all these cases, patients have a high risk of surgery because of existing comorbidities. This case presents a patient suspected of tuberculous pericarditis who underwent diagnostic pericardiocentesis complicated by right ventricular puncture. The catheter in the right ventricle was withdrawn via a second catheter placed in the pericardial cavity. Spontaneous blood control was established, and with no increase in pericardial effusion surgical intervention was not required. This method can be applied in certain conditions, including cardiac injury caused by pericardiocentesis or intracardiac manipulations, thus eliminating the need for high-risk surgical intervention.
心包穿刺术是一种用于治疗因感染、炎症或恶性肿瘤等情况导致的心包填塞病例的挽救生命的操作,也适用于经皮冠状动脉介入治疗、心脏装置植入或导管消融术后出现的心包填塞。尽管有先进的成像方法,但并发症的风险仍然很大。特别是在将导管推进心腔或发生心脏壁破裂的情况下,可能需要紧急手术干预。此外,在所有这些情况下,由于存在合并症,患者的手术风险很高。本病例介绍了一名疑似结核性心包炎的患者,其在进行诊断性心包穿刺术时并发右心室穿刺。通过在心包腔内放置的另一根导管将右心室内的导管拔出。实现了自发的血液控制,且心包积液未增加,因此无需手术干预。这种方法可应用于某些情况,包括心包穿刺术或心内操作引起的心脏损伤,从而无需进行高风险的手术干预。