Pericardiocentesis

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General Information

DEFINITION--The needle aspiration of excess fluid from the pericardial sac.

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BODY PARTS INVOLVED--Pericardium, a 2-layered membrane that surrounds the heart and the roots of the great blood vessels (aorta, pulmonary artery, pulmonary vein and vena cava).

REASONS FOR SURGERY--To remove abnormal fluid collections between the pericardium layers. The fluid may be there because the heart is inflamed, infected or injured (fluid may be blood).

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Excess alcohol consumption.

What To Expect

WHO OPERATES--Cardiothoracic surgeon; cardiologist (sometimes).

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Chest x-rays; CT scan; sonogram.
• During surgery: Chest x-rays.
• After surgery: Chest x-rays; fluid examination.

ANESTHESIA--Local anesthesia.

DESCRIPTION OF OPERATION

• Patient lies down on back with upper torso elevated about 60 degrees with arms supported by pillows.
• An I.V. is started and local anesthetic injected.
• The pericardiocentesis needle is inserted into chest wall between the left rib margin adjacent to the breastbone, usually into the space between the 5th and 6th ribs.
• The needle is advanced until fluid can be aspirated.

POSSIBLE COMPLICATIONS--Heartbeat irregularities, inadvertent organ or artery puncture (all rare).

AVERAGE HOSPITAL STAY--0 to 1 day for procedure. Total time varies according to underlying disorder.

PROBABLE OUTCOME--Successful removal of fluid allowing normal heart function to resume.

Postoperative Care

GENERAL MEASURES

• Blood pressure, pulse and respiratory rate will be measured and recorded.
• No smoking.

You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

ACTIVITY---Avoid vigorous exercise until your doctor determines healing is complete.

Low-salt; low--fat.

• Vitamin and mineral supplements (sometimes).

Call Your Doctor If

Any of the following occurs:

• You become short of breath.
• You become anxious.
• Chest pain worsens.

From the Complete Guide to Symptoms, Illness & Surgery by H. Winter Griffith, M.D. © 1995 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange