NDLI: Controlled pericardiocentesis in patients with cardiac tamponade complicating aortic dissection: experience of a centre without cardiothoracic surgery.

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Controlled pericardiocentesis in patients with cardiac tamponade complicating aortic dissection: experience of a centre without cardiothoracic surgery.

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Controlled pericardiocentesis in patients with cardiac tamponade complicating aortic dissection: experience of a centre without cardiothoracic surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cruz, Inês Stuart, Bruno Caldeira, Daniel Morgado, Gonçalo Gomes, Ana C. Almeida, Ana R. Loureiro, Maria J. João, Isabel Cotrim, Carlos Pereira, Hélder
Description	Country affiliation: Portugal Author Affiliation: Cruz I ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal inesmariarosariocruz@gmail.com.); Stuart B ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Caldeira D ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Morgado G ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Gomes AC ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Almeida AR ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Loureiro MJ ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); João I ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Cotrim C ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.); Pereira H ( Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.)
Abstract	BACKGROUND: Cardiac tamponade has been reported in 18.7% of patients with acute type A aortic dissection and its presence is associated with worse outcomes. Emergency aortic repair together with intra-operative pericardial drainage is the recommended treatment approach. However, controversy surrounds how to manage patients with haemopericardium and cardiac tamponade who cannot survive until surgery. PURPOSE: To describe a case series of patients with critical cardiac tamponade complicating aortic dissection admitted to a hospital without cardiothoracic surgery, and in whom preoperative controlled pericardial drainage was performed. METHODS AND RESULTS: Single centre retrospective study: during a nine-year period, 21 patients with Stanford type A aortic dissection were admitted at our centre; six of them (28.6%) presented clinical and echocardiographic signs of cardiac tamponade (four males; mean age 58±17 years). In this subgroup, controlled pericardiocentesis was safely performed with no major immediate complications and it was effective in five patients, improving haemodynamic instability and allowing transfer to the operating room. CONCLUSIONS: Preoperative controlled pericardiocentesis can be lifesaving when managing patients with critical cardiac tamponade (pulseless electrical activity or refractory hypotension) complicating acute type A aortic dissection, namely when cardiac surgery is not immediately available.
File Format	HTM / HTML
ISSN	20488726
Issue Number	2
Volume Number	4
e-ISSN	20488734
Journal	European Heart Journal: Acute Cardiovascular Care
Language	English
Publisher	Sage Publications
Publisher Date	2015-04-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology Aneurysm, Dissecting Complications Aortic Aneurysm, Thoracic Cardiac Surgical Procedures Cardiac Tamponade Surgery Pericardial Effusion Pericardiocentesis Methods Adult Aged Etiology Echocardiography, Transesophageal Electrocardiography Female Hospital Units Humans Male Middle Aged Patient Selection Instrumentation Retrospective Studies Risk Factors Treatment Outcome Journal Article
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Cardiology and Cardiovascular Medicine

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