Emir Karaçağlar, Tansel Erol, Selçuk Baysal, Hafize Corut, İlyas Atar, Haldun Müderrisoğlu

Perikart Efüzyonu Yönetiminde Subksifoid Perkütan Kateter Drenaj Etkinliği

Amaç: Perikart efüzyonu sıkça karşılaşılabilen bir durumdur ve perikardiyosentez gerektiren perikart efüzyonlarının nedenleri çok değişkendir. Bu çalışmada klinik uygulamada sıkça tercih edilen geleneksel yöntemle floroskopi eşliğinde perikart sıvısı boşaltılan hastalardaki en sık etiyolojiyi ve işlemin tanısal değerinin yeterliliğinin araştırılması amaçlanmıştır. Gereç ve yöntemler: Haziran 2008 ve Ocak 2010 tarihleri arasında kliniğimize başvuran hastaların tıbbi kayıtları geriye dönük olarak incelendi.Bulgular: Hastaların ortalama yaşı 54.9± 16.7 yıldı ve hastaların 42' si bayandı (%59.2). En sık ilk başvuru şikayeti solunum güçlüğüydü (%94.3). Ekokardiyografide 58 hastada (%81.6) tamponad saptandı. Akciğer kanseri en sık saptanan kanser türüydü (15 hasta). Ortalama boşaltma süresi 1.7± 1.0 gün, toplam boşaltılan sıvı hacmi 1297 ± 474 ml idi. Hastaların %43,6' sında boşaltılan sıvı kanlı vasıftaydı. Histopatolojik incelemede sadece 8 hastada (%25.8) kanser hücreleri gösterilebildi. Sekiz hastanın ise perikart sıvı örneklerinde iltihabi hücreler saptandı. Sıvı örneklerinden yapılan ekimlerde 4 vakada mikroorganizma üremesi mevcuttu. İki hastada işleme bağlı komplikasyon görüldü. İlk 30 günde 8 hastada (%11.2) yineleyen sıvı toplanması oldu ve bu hastaların hepsi kanser hastalarıydı.Sonuç: Hastalarımız arasında boşaltım gerektiren perikart efüzyonunun en sık etyolojik nedeni kanserdi. Kısa boşaltma süreleri ve altta yatan kanser yineleme ile ilişkili bulunmuştur.

Anahtar Kelimeler:

Perikart hastalıkları, perikart efüzyonu, tamponad

Effectiveness of Subxiphoid Percutaneous Catheter Drainage in Management of Pericardial Effusions

Objective: Pericardial effusion is a common finding in everyday practice and causes of pericardial effusion requiring pericardiocentesis are very complex. We aimed to investigate the most common etiology of large pericardial effusions and diagnostic value of pericardiocentesis through a needle between our patients who underwent fluoroscopy guided pericardiocentesis because of large pericardial effusion or tamponade.Materials and methods: Medical records of patients between June 2008- January 2010 were evaluated retrospectively.Results: Mean age was 54.9± 16.7 years, and 42 (59.2%) of patients were female. Most common presenting symptom was dispnea (94.3%). Echocardiographic analysis showed tamponade in 58 patients (81.6%). Lung malignancy was the most common malignancy (15 patients). The average drainage period was 1.7± 1.0 day, and total drainage volume was 1297 ± 474 ml. The fluid was hemorrhagic in 31 (43.6%) patients. Histopathological examination of the pericardial fluid was positive for malignant cells in 8 (25.8%) of the 31 patient. Acute inflammatory cells were seen in 8 pericardial fluid samples. Microbiologic cultures identified the microorganisms in 4 cases. Periprocedural complications were seen in 2 patients. Recurrence was seen in 8 (11.2%) patients within 30 days, and all of these 8 patients had malignancy. Conclusion: Malignancy is the most common cause of pericardial effusion requiring pericardiocentesis drainage in our hospital. Short drainage periods and underlying malignancy is associated with recurrence.

Keywords:

Pericardial Disease, pericardial effusion, tamponade,

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