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Pericardiocentesis

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Pericardiocentesis, also called a percardial tap or percutaneous pericardiocentesis, is a procedure in which a needle and catheter is used to remove fluid from the sac around the heart (pericardium). This fluid is then tested for signs of cancer, injury, heart failure, pericarditis, renal failure, infection, or aneurysm.

Causes of Pericardial Effusion
  1. Cancer
  2. Cardiac perforation
  3. Injury to the heart
  4. Heart failure
  5. Pericarditis
  6. Kidney failure
  7. Infection
  8. Aneurysm rupture
  1. Cardiac tamponade
  2. The doctor may want to examine fluid around the heart to check for inflammation, cancer, or an autoimmune disorder.
  1. Before the procedure, your doctor will ask you about your health history as well as any medication that you are taking and if you have any allergies. Some may need to be stopped before the procedure, especially if you are taking any blood thinning medication. Please bring a list of all medications that you are taking with you to the hospital.
  2. You may need to avoid food and water for six to eight hours before the procedure or as recommended by the doctor.
  3. You will likely be able to return home the same day or, under certain circumstances, the next day so please arrange for someone to take you home from the hospital.
The procedure is usually done in the cardiac catheterization lab, except in severe cases of cardiac tamponade.
  1. You will be asked to lie down flat in the Cardiac Catheterization Lab.
  2. You will be given a mild sedative to relax you, but you will be awake during the procedure.
  3. An intravenous line will be started in case you need fluids or medication.
  4. A local anesthetic will be injected to numb and area on your chest. A needle will then be inserted through your chest and into the pericardial sac around your heart. X-ray or echocardiography may be used to ensure the position of the needle.
  5. The fluid around your heart will then be collected or drained, as needed. The procedure takes 20 to 60 minutes.
You will be monitored for several hours after the procedure.
While the procedure is fairly safe, especially when imaging is used to guide the needle, there are still possible risks to a pericardiocentesis, including:
Before the Procedure
  • You should plan to stay in Thailand for at least two weeks through the duration of your treatment.
  • It is recommended that you stay in a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure or from the day of the procedure to the day of your follow-up appointment.
After the Procedure
  • At your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation regarding your surgery or procedure and all other relevant documentation for traveling.
  • Avoid activities that require strenuous pulling, pushing, shoving, or lifting as well as kneeling. These can cause bleeding from the injection site.
  • Keep the injection site clean and dry until it is fully healed. Please let the doctor know if you experience redness, swelling, and/or severe pain. If the bleeding does not stop, please place pressure on the site and talk to your doctor immediately.
  • When traveling by air, if you are seated in Economy Class, please choose an exit row or bulkhead seat for convenience in getting up and moving around every 15-30 minutes. Flex your ankles regularly to prevent deep vein thrombosis.
  • Please take all medication prescribed by your doctor. Carry the appropriate dosage of mediation in your carry-on luggage when you travel as well as a few extra doses in case of an emergency. Carry the prescription for all your medication to avoid problems at the airport.
The success of the procedure depends on a number of factors. Please discuss the likelihood of success with your doctor before the procedure.
 
What if the procedure is not performed?
Please discuss specific risks of not having the procedure done with your doctor.
 
When a pericardiocentesis is indicated, there are no alternatives. If pericardiocentesis fails, another treatment may be performed.
 

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