Pericardiocentesis in Dogs (Canis) | Vetlexicon
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Pericardiocentesis

ISSN 2398-2942

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Synonym(s): Pericardial drainage

Introduction

  • There is a potential space between the myocardium and the pericardium (the pericardial sac).
  • This may become distended with fluid.
  • Pressure within the pericardial sac compromises cardiac function (cardiac tamponade) - particularly by causing collapse of the thinner-walled right ventricle.
  • Cardiac tamponade → acute congestive heart failure Heart: congestive heart failure.

Uses

Advantages

  • Life-saving.
  • Minimally invasive procedure when correctly performed.
  • Produces rapid benefit to patient.

Disadvantages

  • Risk of lacerating myocardium or coronary arteries.
  • May be unable to drain all fluid from pericardial sac.
  • Risk of recurrence of fluid accumulation.

Technical problems

  • Some experience of the procedure and moderate dexterity is required.

Alternative techniques

  • Pericardectomy- but requires thoracotomy Thorax: thoracotomy (intercostal) and is an invasive procedure.
  • Not appropriate in acute cases as cardiac function may be insufficient to tolerate general anesthesia.

Time required

Preparation

  • Radiography Radiography: thorax may suggest pericardial effusion.
  • Preferably ultrasonography should be used to confirm pericardial fluid Heart pericardial effusion - 2-D ultrasound.
  • Place intravenous catheter to allow drug and fluid administration if necessary.

Procedure

  • 10-30 minutes (depending on quantity of fluid and ease with which it can be drained).

Decision taking

Criteria for choosing test

  • If cardiac function is compromised by presence of fluid then drainage is indicated.
  • Must confirm fluid presence. Cardiomegaly due to primary heart disease (eg myocardial or valvular disease) can be confused with pericardial fluid.

Risk assessment

  • Small risk associated with procedure is outweighed by likelihood of fatality if condition untreated.

Requirements

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Preparation

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Technique

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Tobias A H (2010)Pericardial diseases.In: Ettinger S J, Feldman E CTextbook of Veterinary Internal Medicine.7th edn. Saunders Elsevier. Chapter 253, pp 1342-1352.
  • Kienle R D, Kittleson M D (2005)Pericardial disease and cardiac neoplasia.In:Small Animal Cardiovascular Medicine. St Louis: Mosby.
  • Sisson D, Thomas W (1999)Pericardial disease and cardiac tumours.In: Fox P R, Sisson D, Moise N STextbook of Canine and Feline Cardiology. 2nd edn. W B Saunders Company, Philadelphia. Chapter 29, pp 679-701.