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Pericardiocentesis

General Information

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

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.
  • 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

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