Therapeutic Pericardiocentesis Under the Guidance of Transthoracic Echocardiography with the Use of Agitated Saline Contrast

Abstract

Cardiac tamponade is a life-threatening condition requiring urgent intervention. It may either be drained surgically or percutaneously. Percutaneous drainage of pericardial effusion bears the risk of laceration and perforation of the myocardium and the coronary vessels, air embolism, pneumothorax, dysrhythmias, puncture of the peritoneal cavity and abdominal viscera, internal mammary artery fistula, acute pulmonary edema, and purulent pericarditis. Here, we report an easy and safe approach for pericardiocentesis under the guidance of agitated saline contrast injection through a Seldinger needle before inserting guidewire and catheter. This cheap, easy, feasible, and comfortable method of injection of agitated saline contrast before the insertion of guidewire and catheter may prevent the undesired complications.