Blind subxiphoid pericardiotomy to relieve critical acute hemopericardium

Kurimoto Y et al. – Blind subxiphoid pericardiotomy (BSP) was safe and effective for cardiac tamponade due to acute hemopericardium. Critical complications during percutaneous catheter drainage (PCD) for hemopericardium could not be avoided in some cases because of clots in the pericardium.

Methods

• The authors designed a prospective observational study to evaluate blind subxiphoid pericardiotomy (BSP) for critical cardiac tamponade due to hemopericardium.
• Emergency patients (n=148) with acute hemopericardium secondary to trauma (n=12), acute aortic disease (n=122), or cardiac rupture following acute myocardial infarction (n=14) were the subjects.
• Early results were compared between the BSP group (n=53) and the PCD group (n=95).

Results

• BSP was effective at relieving cardiac tamponade in all 53 cases, but PCD was ineffective in 12 cases (12.6 %, p=0.008).
• Procedure–related complication rates of BSP and PCD were 0 and 16.8 %, respectively (p=0.002).
• Survival rates for the BSP and PCD groups were 18.9 and 6.3 %, respectively (p=0.018).
• Since 2005, when the authors discarded the restriction that only board–certified surgeons should perform BSP, acute care physicians (including trainees) have performed BSP for 22 patients without procedure–related complications.

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