title: Echocardiographically guided pericardiocentesis - the gold standard for the management of pericardial effusion and cardiac tamponade.
abstract: BACKGROUND
  The conventional surgical pericardiotomy and blind needle-puncture pericardiocentesis using a subxiphoid approach have been reported to have only moderate success rates and to be associated with unacceptably high rates of morbidity and mortality. More recently, echocardiographically guided pericardiocentesis was reported to improve considerably the likelihood of success and the safety of this procedure.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of echocardiographically guided pericardiocentesis in the authors' institution.
  
  
  METHODS
  A series of consecutive patients who underwent percutaneous pericardiocentesis at the Hamilton General Hospital, Hamilton, Ontario, from June 1994 to December 1998.
  
  
  RESULTS
  Forty-one patients underwent a total of 46 echocardiographically guided pericardiocentesis procedures. The procedure was successful in 100% of attempts. Clinical complications occurred in two (5%) patients: one patient with known coagulopathy developed hemothorax and one patient developed purulent pericarditis several days after the procedure. There were no deaths, and no patient required urgent referral for surgical management.
  
  
  CONCLUSIONS
  Echocardiographically guided pericardiocentesis is safe and effective, and is the method of choice for therapeutic and diagnostic drainage of pericardial effusions. While echocardiographically guided pericardiocentesis was described originally at centres with large volumes of patients with clinically significant pericardial effusions and with extensive experience in using this technique, similar high success and low complication rates were attained at an institution with relatively low numbers of patients requiring pericardial drainage.
authors.affiliation: Hamilton Health Sciences Corporation and McMaster University, Hamilton, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Salem
authors.forename: A
authors.initials: A
authors.lastname: Mulji
authors.forename: E
authors.initials: E
authors.lastname: Lonn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000601:surgery*; D020519:Pericardiocentesis / Q000379:methods / Q000592:standards*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome