PERICARDIOCENTESIS GUIDED BY 2-DIMENSIONAL CONTRAST ECHOCARDIOGRAPHY

The clinical application of two-dimensional contrast echocardiography to pericardiocentesis was investigated in 20 patients with pericardial effusion. Multiple views were obtained to determine the ideal needle entry route. During pericardiocentesis, after 5 to 10 mL of pericardia l fluid was withdrawn, 3 to 5 mL of agitated saline solution was injec ted through the exploring needle into the pericardium and a cloud of e choes indicated the needle's position. Contrast echoes were observed i n all 20 patients. The procedure was performed smoothly in all patient s except two (10%): the exploring needle was inserted into the right a trium in one patient and into the right ventricle in the other patient . The former promptly underwent a surgical drainage procedure, and the latter a second pericardiocentesis successfully guided by contrast ec hocardiography. The pericardial fluid was simply, safely, and successf ully aspirated in the other 18 patients. We conclude that two-dimensio nal contrast echocardiography is valuable for locating needle position , thus facilitating successful pericardiocentesis in clinical practice .