Intrapericardial fibrinolytic therapy in purulent pericarditis.
OBJECTIVE
Purulent pericarditis is a rare disease that is being conventionally managed with intravenous antibiotics and pericardial drainage. In our study, we used intrapericardial fibrinolytic treatment together with pericardiocentesis and antibiotic therapy. We evaluated the role of intrapericardial fibrinolytic treatment in nine purulent pericarditis patients.


METHODS
Six children and three adult patients with purulent pericarditis, aged between 5 and 50 years, were treated with intrapericardial fibrinolysis by streptokinase. Intrapericardial drainage catheter was placed into the subxyphoidal localization under local anaesthesia and echocardiography guidance, streptokinase was infused into the pericardial sac as the fibrinolytic agent.


RESULTS
Repeat echocardiograms showed no reaccumulation of pericardial effusions, pericardial thickening or constrictions. No patients had systemic bleeding, arrhythmias, or hypotension. There was one death which was due to sepsis and congestive heart failure.


CONCLUSIONS
We believe that early pericardial drainage and intrapericardial fibrinolysis appears to be safe and effective in the treatment of purulent pericarditis.
Department of Cardiovascular and Thoracic Surgery, Gaziantep University School of Medicine, Gögcaron;üs ve Kalp Damar Cerrahisi Anabilimdali, Kolejtepe, Gaziantep, Turkey. hustunsoy@yahoo.com
Haşim
H
Ustünsoy
Mehmet Adnan
MA
Celkan
Muammer Cumhur
MC
Sivrikoz
Hakki
H
Kazaz
Metin
M
Kilinç
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D020519:Pericardiocentesis; D010493:Pericarditis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000628:therapy; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D014640:Vancomycin; D013300:Streptokinase