Key result
Percutaneous epicardial access in patients with prior cardiac surgery is associated with significant complications, requiring meticulous preparation and understanding of regional anatomy.
Why the study?
Percutaneous pericardial access is increasingly used but carries significant complications, particularly in patients with prior cardiac surgery, requiring meticulous preparation and understanding of anatomy and technique.
Percutaneous epicardial access in patients with prior cardiac surgery carries significant risks and requires meticulous preparation and a thorough understanding of regional anatomy.
Requires heightened caution with prior surgery; leaves open need for safer techniques in prospective studies.
INTRODUCTION: The number of procedures for which percutaneous pericardial access is used for has gradually increased since its initial description, and now includes mapping/ablation, atrial appendage ligation and pericardial biopsy. Areas covered: Successful percutaneous pericardial access is predicated on having a thorough understanding of regional anatomy, indications for attempting pericardial puncture and potential complications with appropriate management which are highlighted in this review. In addition, we will discuss the access technique itself, provide tips and pitfalls and highlight future directions with an emphasis on patients with prior cardiac surgery. Expert commentary: Percutaneous epicardial access, especially in patients with prior cardiac surgery, is associated with significant complications and therefore meticulous preparation is required. Even in experienced centers, unusual circumstances may be crossed.
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Killu et al. (2018) conducted a review in Prior cardiac surgery requiring percutaneous pericardial access. Percutaneous pericardial access was evaluated. Percutaneous epicardial access in patients with prior cardiac surgery is associated with significant complications, requiring meticulous preparation and understanding of regional anatomy.
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