Di Segni E, Lavee J, Kaplinsky E, Vered Z
Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel.
Eur Heart J. 1995 Feb;16(2):184-7. doi: 10.1093/oxfordjournals.eurheartj.a060883.
Percutaneous balloon pericardiostomy was performed in eight severely ill patients with malignancy (seven patients) and chronic renal failure (one patient). To investigate the feasibility of balloon pericardiostomy as a bedside procedure, echocardiography was used in addition to fluoroscopy in monitoring the procedure. The pericardium was entered from the standard subxiphoid site. An 18 to 25 mm, 3 or 4 cm long, balloon catheter, introduced over a stiff guidewire was inflated across the parietal pericardium. Creation of a pericardial opening was obtained in each of the eight patients. Bleeding from the needle entry site was the only complication observed in one patient. The balloon catheter could be localized by echocardiography only in 2/8 cases. Two patients died, 3 and 14 days after the procedure, from the primary disease; six patients were still alive at follow-up ranging from 32 to 342 days. No recurrence of cardiac tamponade was observed in any patient. Percutaneous balloon pericardiostomy is efficacious and safe in relieving pericardial tamponade and preventing its recurrence in severely ill patients. Fluoroscopy is needed to monitor the procedure. The value of echocardiography is limited for follow-up controls of pericardial effusion.
对8例重症患者（7例恶性肿瘤患者和1例慢性肾衰竭患者）实施了经皮球囊心包造口术。为研究球囊心包造口术作为床旁操作的可行性，除荧光透视外还使用超声心动图来监测该操作。经标准剑突下部位进入心包。将一根18至25毫米、3或4厘米长的球囊导管经硬导丝置入后，在脏层心包上进行充气。8例患者均成功造口。仅1例患者出现了穿刺部位出血这一并发症。仅2/8的病例可通过超声心动图定位球囊导管。2例患者在术后3天和14天因原发病死亡；6例患者在32至342天的随访期内仍存活。所有患者均未观察到心脏压塞复发。经皮球囊心包造口术在缓解重症患者的心包压塞及预防其复发方面有效且安全。需要荧光透视来监测该操作。超声心动图在随访心包积液方面的价值有限。
