Pericardial surgery

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Cardiac surgery deals with the surgical treatment of pericardial diseases. The basic operations on the pericardium include:

  • Pericardiocentesis (pericardiocentesis).
  • Creating a pericardial window.
  • Pericardectomy.

Pericardiocentesis[edit | edit source]

Pericardiocentesis

It is a puncture pericardial to evacuate pericardial fluid.

  • In hospital conditions, it is performed under echocardiographic control, which minimizes complications and allows the subsequent introduction of a thin drain.[1]
  • In the field, the pericardium is punctured sightlessly.
    • The patient assumes a semi-sitting position.
    • The epidural needle is inserted to the left of the xiphoid process at an angle of about 45 ° below the ribs towards the left nipple.
    • We are approaching the heart with constant aspirations.
    • We are waiting for a faint thud signaling the penetration of the pericardium and the subsequent aspiration of blood / serous fluid / air.
    • After aspirating the blood, we inject a small amount of blood and see if it clots. Blood from the pericardial space does not contain fibrin and therefore does not clot.
    • Exercise carries the risk of pericardial and cardiac laceration, coronary artery or lungs injury.
    • The lethality of sightlessly pericardiocentesis is about 20 %.


Creating a pericardial window[edit | edit source]

This is a procedure during which we resect the pericardium and establish communication with the pleural cavity (thoracoscopically or from an anterolateral thoracotomy) or with the peritoneal cavity (from a short subxiphoidal incision). This procedure is most often performed in patients with malignant disease (metastases to the pericardium), where fluid accumulates in the pericardial space even after repeated punctures.




Perikardectomy[edit | edit source]

Abriendo Pericardio.JPG

This is a complete removal of the pericardium (from an anterolateral thoracotomy or middle sternotomy). The indication for this procedure is constrictive pericarditis , the most common cause of which is tuberculosis or post-radiation pericarditidis.


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Kategorie:Cardiology Kategorie:Surgery