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Safety and Feasibility of Performing Pericardiocentesis on Patients with Significant Pulmonary Hypertension.

by Ben-Dor, Itsik; Case, Brian C; Forrestal, Brian J; Hashim, Hayder; Kagan, Calvin M; Medvedofsky, Diego; Satler, Lowell F; Tariq, Muhammad U; Waksman, Ron; Yang, Michael; Yerasi, Charan.
Citation: ; Cardiovascular Revascularization Medicine. 20(12):1090-1095, 2019 Dec..Journal: Cardiovascular revascularization medicine : including molecular interventions.Published: ; 2019; ISSN: 1878-0938.Full author list: Ben-Dor I; Case BC; Forrestal BJ; Hashim H; Kagan CM; Medvedofsky D; Rogers T; Satler LF; Tariq MU; Waksman R; Yang M; Yerasi C.UI/PMID: 31870527.Subject(s): Adult | Ventricular Function, Right | Treatment Outcome | Severity of Illness Index | Risk Factors | Risk Assessment | Retrospective Studies | Pulmonary Arterial Hypertension/pp [Physiopathology] | Pulmonary Arterial Hypertension/dg [Diagnostic Imaging] | *Pulmonary Arterial Hypertension/co [Complications] | *Pericardiocentesis | Pericardiocentesis/ae [Adverse Effects] | *Pericardial Effusion/su [Surgery] | Pericardial Effusion/pp [Physiopathology] | Pericardial Effusion/et [Etiology] | Pericardial Effusion/dg [Diagnostic Imaging] | Patient Safety | Middle Aged | Male | Humans | Hemodynamics | Female | Feasibility Studies | Aged, 80 and over | AgedInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.carrev.2019.09.022 (Click here) Abbreviated citation: ; Cardiovasc Revasc Med. 20(12):1090-1095, 2019 Dec.Local Holdings: Available in print through MWHC library: 2002 - present.Abstract: 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.Abstract: 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.Abstract: 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.Abstract: 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.Abstract: 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.

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