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Pericardiocentesis in children: 20-year experience at a tertiary children’s hospital

Part of: Interventional Cardiology

Published online by Cambridge University Press:  26 July 2021

Christopher Herron Open the ORCID record for Christopher Herron [Opens in a new window] ,
Thomas J. Forbes  and
Daisuke Kobayashi
Christopher Herron
Affiliation:
Division of Cardiology, Children’s Hospital of Michigan, Detroit, MI, USA Department of Pediatrics, Central Michigan University College of Medicine, Mount Pleasant, MI, USA
Thomas J. Forbes
Affiliation:
Division of Cardiology, Children’s Hospital of Michigan, Detroit, MI, USA Department of Pediatrics, Central Michigan University College of Medicine, Mount Pleasant, MI, USA
Daisuke Kobayashi*
Affiliation:
Division of Cardiology, Children’s Hospital of Michigan, Detroit, MI, USA Department of Pediatrics, Central Michigan University College of Medicine, Mount Pleasant, MI, USA
*
Author for correspondence: Dr D. Kobayashi, MD, Division of Cardiology, Children’s Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201-2119, USA; Department of Pediatrics, Central Michigan University College of Medicine, Mount Pleasant, MI, USA. Tel: +1 313 745 5481; Fax: +1 313 993 0894. E-mail: dkobayas@dmc.org
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Abstract

Background:

Pericardiocentesis is the invasive percutaneous procedure for acute and chronic excessive accumulation of pericardial fluid. There is a paucity of data on the effectiveness and safety of pericardiocentesis in children.

Objectives:

To evaluate the effectiveness and safety of pericardiocentesis and factors associated with acute procedural failure and adverse events.

Methods:

This was a single-centered retrospective study to describe all the children aged ≤20 years who underwent pericardiocentesis. Data on demographics, etiologies of pericardial effusion, and repeat intervention at follow-up were collected.

Results:

A total of 127 patients underwent 153 pericardiocentesis. The median age was 6.5 years (1 day–20 years) with weight of 17 kg (0.5–125). Most common etiology was post-pericardiotomy syndrome (n = 56, 44%), followed by infectious (12%), malignant (10%), and iatrogenic (9%). Pericardiocentesis was performed more commonly in the catheterisation laboratory (n = 86, 59%). Concurrent pericardial drain placement was performed in 67 patients (53%). Acute procedural success was 92% (141/153). Repeat intervention was performed in 33 patients (22%). The incidence of adverse events was 4.6% (7/153): hemopericardium requiring emergent surgery (n = 2); hemopericardium with hypotension (n = 2); seizure with anesthesia induction (n = 1); and right ventricle puncture with needle (n = 2). Pericardiocentesis at the bedside had a higher rate of acute procedural failure than that in the catheterisation lab (17 versus 1%, p < 0.01). No identifiable risk factors were associated with adverse events.

Conclusions:

Pericardiocentesis was life-saving in children with its high effectiveness and safety even in urgent situations. Although initial pericardiocentesis was effective, one of five patients required re-intervention for recurrent pericardial effusion.

Keywords

Pericardiocentesispericardial effusionpost-pericardiotomy syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 606 - 611
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Herron et al. supplementary material

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