Transtorasik Ekokardiyografi Kılavuzluğunda Yapılan Terapatik Perikardiyosentezde Kontrast Madde Olarak Ajite Serum Kullanılması
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Kardiyak tamponad acil müdahale
gerektiren, hayatı tehdit eden bir hastalıktır. Biriken sıvı cerrahi ya da
perkütan yol ile boşaltılabilir. Perikardiyal efüzyonun perkütan yol ile
boşaltılması, miyokardiyal ve koroner laserasyon, perforasyon, hava embolisi,
pnömotoraks, aritmi, periton yaralanması, abdominal organ hasarı, internal
mamariyen arter fistülizasyonu, akut pulmoner ödem ve pürülan perikardit riski
taşır. Biz bu yazıda perikardiyosentez için kolay ve güvenli bir metod olarak,
perikardiyal boşluğa kateter ve klavuz tel yerleştirmeden önce Seldinger
iğnesinden kontrast amaçlı ajite serum uygulanan bir olguyu sunuyoruz. Basit,
rahat ve kolay uygulanabilir bir yöntem olması nedeniyle kateter ve kılavuz
telin perikardiyal boşluğa yerleştirilmesinden önce uygulan ajite serum
kontrast ile bu istenmeyen komplikasyonların önüne geçilebilir.
Therapeutic Pericardiocentesis Under the Guidance of Transthoracic Echocardiography with the Use of Agitated Saline Contrast
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Cardiac tamponade is a
life-threatening condition requiring urgent intervention. It may either be
drained surgically or percutaneously. Percutaneous drainage of pericardial
effusion bears the risk of laceration and perforation of the myocardium and the
coronary vessels, air embolism, pneumothorax, dysrhythmias, puncture of the
peritoneal cavity and abdominal viscera, internal mammary artery fistula, acute
pulmonary edema, and purulent pericarditis. Here, we report an easy and safe
approach for pericardiocentesis under the guidance of agitated saline contrast
injection through a Seldinger needle before inserting guidewire and catheter.
This cheap, easy, feasible, and comfortable method of injection of agitated
saline contrast before the insertion of guidewire and catheter may prevent the
undesired complications.
___
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2002;77:429-36.
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- 5. Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Outcomes of clinically significant idiopathic pericardial effusion requiring intervention. Am J Cardiol 2003;91:704-7.
- 6. Tsang TS, Freeman WK, Barnes ME, Reeder GS, Packer DL, Seward JB. Rescue echocardiographically guided pericardiocentesis for cardiac perforation complicating catheter-based procedures. The Mayo Clinic experience. J Am Coll Cardiol 1998;32:1345-50.