ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Computed tomography-guided drainage of pericardial effusion
Münacettin Ceviz1, Abdurrahim Çolak1, Necip Becit1, Uğur Kaya1, Hayri Oğul2
Department of Cardiovascular Surgery, Medical Faculty of Atatürk University, Erzurum, Turkey
1Departments of Cardiovascular Surgery, Medical Faculty of Atatürk University, Erzurum, Turkey
2Departments of Radiology, Medical Faculty of Atatürk University, Erzurum, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.9529
Background: This study aims to evaluate the safety and feasibility of computed tomography (CT)-guided drainage of pericardial effusions by using a nephrostomy catheter.

Methods: We performed CT-guided drainage of pericardial effusions on 30 patients (15 males, 15 females; mean age 52±3 years; range 18 to 80 years) in our clinic between December 2005 and November 2011. Only patients who were ineligible for echocardiography-guided drainage were selected. By using the Seldinger technique, a 8 or 10F nephrostomy catheter was inserted into the pericardial space.

Results: Procedure was successful in 29 patients. In one patient, the catheter was able to be placed in the pericardial space, but the fluid was unable to be aspirated. The patient was operated. An organized hematoma was found in the pericardial space. During surgery, a small epicardial laceration was detected on the anterolateral surface of the right ventricle. Serous fluid was aspirated from 12 patients (41%), hemorrhagic fluid from 10 patients (35%), transude from seven patients (24%) and purulent fluid was aspirated from one patient (3.3%). Catheters were removed after a mean duration of 4±2 days. In two (6.6%) patients pericardial effusion recurred and successful drainage was performed by the same method. No new recurrences were observed. No procedure-related death was occurred.

Conclusion: Our study results suggest that CT-guided drainage with a nephrostomy catheter is an effective, safe and feasible procedure in patients who are ineligible for echocardiography-guided drainage. We also believe that this technique is more suitable for patients with postoperative localized pericardial effusions.

Keywords : Cardiac tamponade; pericardial effusion; pericardiocentesis
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