Pericardiocentesis A procedure whereby the pericardial sac i | International surgical boards

Pericardiocentesis

A procedure whereby the pericardial sac is entered via a needle under ultrasonic guidance, the needle is passed medial to cardiac apex, or below the xiphoid process, guided upwards and towards the left shoulder (the above video demonstrate the procedure).

It is used as a diagnostic tool, whereby few millimeters of pericardial fluid is aspirated for analysis e.g diagnosis of pericarditis.

It can also be used therapeutically in case of cardiac temponade.

Complications include (1) Induction of arrhythmia, (2) Injury of a coronary vessel, (3) Puncture of the right ventricle leading to hemorrhage and worsening of the temponade, (4)Introduction of infection.

N.B if temponade was due to free cardiac rupture or aortic dissection, emergency surgery is indicated, pericardiocentesis is not attempted as in most cases it lead to worsening of temponade.