Killu Ammar M, Asirvatham Samuel J
a Department of Cardiovascular Disease, Division of Heart Rhythm Services , Mayo Clinic , Rochester , MN , USA.
b Department of Pediatric Cardiology , Mayo Clinic , Rochester , MN , USA.
Expert Rev Cardiovasc Ther. 2019 Feb;17(2):143-150. doi: 10.1080/14779072.2019.1561276. Epub 2018 Dec 29.
The number of procedures for which percutaneous pericardial access is used for has gradually increased since its initial description, and now includes mapping/ablation, atrial appendage ligation and pericardial biopsy. Areas covered: Successful percutaneous pericardial access is predicated on having a thorough understanding of regional anatomy, indications for attempting pericardial puncture and potential complications with appropriate management which are highlighted in this review. In addition, we will discuss the access technique itself, provide tips and pitfalls and highlight future directions with an emphasis on patients with prior cardiac surgery. Expert commentary: Percutaneous epicardial access, especially in patients with prior cardiac surgery, is associated with significant complications and therefore meticulous preparation is required. Even in experienced centers, unusual circumstances may be crossed.
自经皮心包穿刺首次被描述以来，其应用的操作数量逐渐增加，目前包括标测/消融、心房附件结扎和心包活检。涵盖领域：成功的经皮心包穿刺取决于对区域解剖结构的透彻理解、尝试心包穿刺的适应症以及潜在并发症及其适当的处理方法，本综述将重点阐述这些内容。此外，我们将讨论穿刺技术本身，提供技巧和注意事项，并强调未来的发展方向，重点关注有心脏手术史的患者。专家评论：经皮心外膜穿刺，尤其是在有心脏手术史的患者中，会伴有严重并发症，因此需要精心准备。即使在经验丰富的中心，也可能会遇到特殊情况。
