Pericardiocentesis guided by two-dimensional contrast echocardiography.
The clinical application of two-dimensional contrast echocardiography to pericardiocentesis was investigated in 20 patients with pericardial effusion.  Multiple views were obtained to determine the ideal needle entry route.  During pericardiocentesis, after 5 to 10 mL of pericardial fluid was withdrawn, 3 to 5 mL of agitated saline solution was injected through the exploring needle into the pericardium and a cloud of echoes indicated the needle's position.  Contrast echoes were observed in all 20 patients.  The procedure was performed smoothly in all patients except two (10%): the exploring needle was inserted into the right atrium in one patient and into the right ventricle in the other patient. The former promptly underwent a surgical drainage procedure, and the latter a second pericardiocentesis successfully guided by contrast echocardiography.  The pericardial fluid was simply, safely, and successfully aspirated in the other 18 patients.  We conclude that two-dimensional contrast echocardiography is valuable for locating needle position, thus facilitating successful pericardiocentesis in clinical practice.
Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taipei, Taiwan, Republic of China.
H T
HT
Chiang
M
M
Lin
D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010496:Pericardium / Q000473:pathology / Q000601:surgery; D011677:Punctures / Q000379:methods