PPS diagnosis was established in patients with new or worsened pericardial effusion greater than 5 mm on echocardiography and/or new or worsened pleural effusion confirmed by chest x-ray within 6 weeks after pericardiotomy
cardiac surgery procedure that had at least one of the following additional clinical signs: fever with no obvious infection, elevation of C-reactive protein (CRP) with no obvious infection, pleuritic chest pain, and pericardial rub.
Acute pericardial disease: Pericardiocentesis and Percutaneous Pericardiotomy
. In: Mebazaa A, Gheorghiade M, Zannad FM, Parrillo JE.
Surgery was performed in 7 including excision of intrapericardial xanthogranuloma, pericardial tissue biopsy in a child with restrictive cardiomyopathy, and 5 patients with purulent pericarditis who underwent drainage procedures including pericardiotomy
and mediastinal exploration for mediastinal fluid drainage and removal of adhesions in 2 patients (Table 2).
Treatment options for pericardial fluid drainage include percutaneous pericardiocentesis and surgical pericardiotomy
. Percutaneous pericardiocentesis provides rapid drainage; however, approximately 40% of patients go on to require surgical pericardiotomy
after initial drainage .
, we found a small amount of blood and noticed a small hole in the anterior wall of the left ventricle, without bleeding.
It was executed under ultrasound guidance and confirmation of a decompressive pericardiocentesis and pericardiotomy
with catheter placement for drainage, draining a total of 300 mL of serohematic fluid, achieving hemodynamic compensation and electrocardiogram voltage increase, sinus rhythm, and wide QRS in cardiovisoscopy.
Refractory cases require urgent thoracotomy with pericardiotomy
along with high flow oxygen as it helps in the resorption of the air from the cavity [15, 22].
The heart was exposed by a fifth-intercostal space thoracotomy and followed by pericardiotomy
. A 6-0 silk suture was placed around the left anterior descending artery (LAD) between the first branch of the LAD and the left atrium.
The patient was taken to the operating room on 31/3/2013, where a median sternotomy followed by pericardiotomy
Cannulation of the ascending aorta and right atrium was performed after median sternotomy and pericardiotomy
. After heparin (Darou Pakhsh Pharma Chem Co., Tehran, Iran) administration, standard CPB was started using a disposable hollow fiber oxygenator.
Intravenous administration of Magnesium (Mg levels were kept over 2 mgr/dl) and potassium were given (K levels were kept over 4 mgr/dl) before pericardiotomy
was done for all patients.
Interventional Pericardiology: Pericardiocentesis, Pericardioscopy, Pericardial Biopsy, Balloon Pericardiotomy
and Intrapericardial Therapy.