CT-guided pericardiocentesis.
OBJECTIVE
Pericardial effusion in patients who have recently undergone cardiac surgery is often trapped in compartments. CT of the pericardium provides good information about the distribution of pericardial fluid in the postoperative period after cardiac surgery. Contrary to echocardiography, CT imaging is not affected by postoperative mediastinal emphysema and pain from the wound. A method for CT-guided pericardiocentesis was developed.


METHODS
CT-guided pericardiocentesis was carried out with a stereotactic device in 10 patients. The pericardium was punctured with a 0.9-mm needle and a 0.46-mm guide wire was introduced through the needle. An indwelling catheter was introduced over the guide wire and was left in the pericardium. Both the subxiphoid and parasternal approaches were used.


RESULTS
CT guidance facilitated placement of an indwelling catheter into the pericardial space in positions difficult to reach in patients with postoperative pericardial compartments, i.e. near the right atrium and adjacent to the cardiac apex/left ventricle.


CONCLUSIONS
CT-guided pericardiocentesis offers a new possibility in patients where fluoroscopically or echocardiographically guided pericardiocentesis is difficult.
Department of Diagnostic Radiology, University Hospital, Uppsala, Sweden.
O
O
Duvernoy
A
A
Magnusson
D002408:Catheters, Indwelling; D004322:Drainage / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D011677:Punctures; D014057:Tomography, X-Ray Computed