is a procedure where fluid is aspirated from the pericardium
(the sac enveloping the heart
It is generally done under ultrasound
guidance, to minimize complications. There are two locations that pericardiocentesis can be performed without puncturing the lungs.
- One location is through the 5th or 6th intercostal space at the left sternal border at the cardiac notch of the left lung.
- The other location is through the infrasternal angle.
Indications include cardiac tamponade
, as well as the need to analyze the fluid surrounding the heart. Cardiac tamponade is a condition in which an accumulation of fluid within the pericardium creates excessive pressure, which then prevents the heart from filling normally with blood. This can critically decrease the amount of blood that is pumped from the heart, which can be lethal. The removal of the excess fluid reverses this dangerous process. Examples of the need for fluid analysis would be to differentiate whether a fluid collection within the pericardium is due to an infection
, spread of cancer
, or possibly an autoimmune
In cases where longer term drainage is needed, the cardiothoracic surgeon can create a pericardial window. This involves the removal of a section of the pericardium, and the placement of a chest tube.