Perikardpunktion – Schritt für Schritt

Eine Perikardpunktion dient einerseits der notfallmäßigen und sofortigen Entlastung einer Herztamponade, andererseits lässt sich das Verfahren zu differenzialdiagnostischen Zwecken einsetzen – jedoch meist nur mit mäßigem Erfolg. Dem gegenüber stehen hohe Risiken, wie Verletzungen von Lunge, Leber und dem Herzen selbst. Dieser Schritt-für-Schritt-Beitrag erläutert das sichere Vorgehen einer echokardiografisch gestützten Perikardpunktion.

Abstract

A pericardial effusion can be caused by malignant, infectious and autoimmune diseases or by trauma, such as a coronary artery rupture during a cath procedure. In the case of a cardiac tamponade a pericardiocentesis has to be performed immediately.

Additionally, a pericardiocentesis may also be performed for diagnostic purposes. However, since histologic and microbiologic findings are rarely pointing to hitherto unsuspected results, the risk of the procedure must very carefully be weighed against its benefits. The risks of a pericardiocentesis include injuries to the lungs and liver as well as the heart itself, such as puncture of the right ventricle or the rupture of a coronary artery.

This article is a step-by-step description of how to safely perform an ultrasound-guided pericardiocentesis.

Schlüsselwörter

Perikardpunktion - Perikarderguss - Perikardtamponade

Key words

pericardiocentesis - pericardial effusion - cardiac tamponade

Publication History

Article published online:
20 October 2020

• Literatur

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• 2 Maisch B, Seferovic PM, Ristic AD. et al. Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. Eur Heart J 2004; 25: 587-610
• 3 Petri N, Ertel B, Gassenmaier T. et al. „Blind“ pericardiocentesis: A comparison of different puncture directions. Catheter Cardiovasc Interv 2018; 92: E327-E332