Safety and Feasibility of Performing Pericardiocentesis on Patients with Significant Pulmonary Hypertension.
Safety and Feasibility of Performing Pericardiocentesis on Patients with Significant Pulmonary Hypertension.
- 2019
Available in print through MWHC library: 2002 - present
BACKGROUND/PURPOSE: Pericardial effusion (PE) is a complication of pulmonary hypertension (PHT) and, specifically, pulmonary arterial hypertension (PAH), that confers a worse prognosis. The safety of performing pericardiocentesis in patients with PHT has not been established. We aimed to assess the safety and feasibility of performing pericardiocentesis in patients with significant PHT. CONCLUSIONS: Pericardiocentesis is a safe procedure, including in patients with significant PHT, including those with WHO Group I PAH. We advocate the use of invasive hemodynamic monitoring in patients with significant PHT. METHODS/MATERIALS: We performed a retrospective analysis from August 2013 to December 2018 at our tertiary-care center of patients who underwent a pericardiocentesis procedure. Patients, procedure, echocardiographic findings, any major intraprocedural complications, and post-procedural related complications up to 30days were recorded. Specifically, we studied patients with significant PHT. RESULTS: The cohort included 170 patients, with an average age of 62.6years and an even distribution of gender and co-morbidities. The etiology for the PE varied. Major complications were rare (1.7%) and only 10 patients (5.9%) required re-intervention for reaccumulation of fluid. There were 27 patients (15.9%) with significant PHT, 5 with World Health Organization (WHO) Group I PAH (2.94%). In the entire cohort, there were only 3 major complications (1.7%), none among PHT patients. SUMMARY: Pericardiocentesis tends to be a safe procedure. However, the safety of performing pericardiocentesis in patients with significant pulmonary hypertension has not been well established. We aimed to assess the safety and feasibility of performing pericardiocentesis, and specifically in patients with significant PHT out our tertiary center by performing a retrospective analysis. Copyright (c) 2019 Elsevier Inc. All rights reserved.
English
1878-0938
10.1016/j.carrev.2019.09.022 [doi] S1553-8389(19)30647-5 [pii]
*Pericardial Effusion/su [Surgery]
*Pericardiocentesis
*Pulmonary Arterial Hypertension/co [Complications]
Adult
Aged
Aged, 80 and over
Feasibility Studies
Female
Hemodynamics
Humans
Male
Middle Aged
Patient Safety
Pericardial Effusion/dg [Diagnostic Imaging]
Pericardial Effusion/et [Etiology]
Pericardial Effusion/pp [Physiopathology]
Pericardiocentesis/ae [Adverse Effects]
Pulmonary Arterial Hypertension/dg [Diagnostic Imaging]
Pulmonary Arterial Hypertension/pp [Physiopathology]
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Treatment Outcome
Ventricular Function, Right
MedStar Heart & Vascular Institute
Journal Article
Available in print through MWHC library: 2002 - present
BACKGROUND/PURPOSE: Pericardial effusion (PE) is a complication of pulmonary hypertension (PHT) and, specifically, pulmonary arterial hypertension (PAH), that confers a worse prognosis. The safety of performing pericardiocentesis in patients with PHT has not been established. We aimed to assess the safety and feasibility of performing pericardiocentesis in patients with significant PHT. CONCLUSIONS: Pericardiocentesis is a safe procedure, including in patients with significant PHT, including those with WHO Group I PAH. We advocate the use of invasive hemodynamic monitoring in patients with significant PHT. METHODS/MATERIALS: We performed a retrospective analysis from August 2013 to December 2018 at our tertiary-care center of patients who underwent a pericardiocentesis procedure. Patients, procedure, echocardiographic findings, any major intraprocedural complications, and post-procedural related complications up to 30days were recorded. Specifically, we studied patients with significant PHT. RESULTS: The cohort included 170 patients, with an average age of 62.6years and an even distribution of gender and co-morbidities. The etiology for the PE varied. Major complications were rare (1.7%) and only 10 patients (5.9%) required re-intervention for reaccumulation of fluid. There were 27 patients (15.9%) with significant PHT, 5 with World Health Organization (WHO) Group I PAH (2.94%). In the entire cohort, there were only 3 major complications (1.7%), none among PHT patients. SUMMARY: Pericardiocentesis tends to be a safe procedure. However, the safety of performing pericardiocentesis in patients with significant pulmonary hypertension has not been well established. We aimed to assess the safety and feasibility of performing pericardiocentesis, and specifically in patients with significant PHT out our tertiary center by performing a retrospective analysis. Copyright (c) 2019 Elsevier Inc. All rights reserved.
English
1878-0938
10.1016/j.carrev.2019.09.022 [doi] S1553-8389(19)30647-5 [pii]
*Pericardial Effusion/su [Surgery]
*Pericardiocentesis
*Pulmonary Arterial Hypertension/co [Complications]
Adult
Aged
Aged, 80 and over
Feasibility Studies
Female
Hemodynamics
Humans
Male
Middle Aged
Patient Safety
Pericardial Effusion/dg [Diagnostic Imaging]
Pericardial Effusion/et [Etiology]
Pericardial Effusion/pp [Physiopathology]
Pericardiocentesis/ae [Adverse Effects]
Pulmonary Arterial Hypertension/dg [Diagnostic Imaging]
Pulmonary Arterial Hypertension/pp [Physiopathology]
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Treatment Outcome
Ventricular Function, Right
MedStar Heart & Vascular Institute
Journal Article