Article: Intra-pericardial thrombin injection as bailout strategy in iatrogenic pericardial tamponade.
2022 Volume 31, Issue 2, Page(s) 61–67
Abstract: Background: Cardiac tamponade is a rare but life-threatening complication of cardiac interventions. Despite prompt pericardiocentesis, clinical management can be challenging and sometimes haemodynamic stabilisation is difficult to achieve. Intra- ... ...
| Abstract | Background: Cardiac tamponade is a rare but life-threatening complication of cardiac interventions. Despite prompt pericardiocentesis, clinical management can be challenging and sometimes haemodynamic stabilisation is difficult to achieve. Intra-pericardial thrombin injection after pericardiocentesis promotes haemostasis and acts as a sealing agent, as previously described for left ventricular free-wall rupture. We aimed to evaluate intra-pericardial thrombin injection as a bailout strategy for pericardial tamponade following percutaneous cardiac interventions. Methods: In a 5-year single-centre retrospective analysis we identified 31 patients with cardiac tamponade due to percutaneous intracardiac procedures. Intra-pericardial thrombin injection as a bailout strategy was administered in 5 of 31 patients (16.1%). Results: Patients receiving intra-pericardial thrombin were in a more critical state when thrombin was applied, as demonstrated by a higher rate of resuscitation (40% versus 26.9%) and a trend toward a prolonged stay in the intensive care unit (177.6 ± 84.0 vs 98.0 ± 31.4 h). None of the patients with pericardial tamponades treated with intra-pericardial thrombin needed cardiothoracic surgery. Mortality after 30 days was lower with intra-pericardial thrombin injection than with standard treatment (0% vs 15.4%). We observed no complications using intra-pericardial thrombin. Conclusion: Intra-pericardial thrombin injection could be considered as a bailout strategy for patients with iatrogenic pericardial tamponade due to percutaneous procedures. We recommend further evaluation of this technique in the clinical management of refractory pericardial tamponade. |
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| Language | English |
| Publishing date | 2022-06-01 |
| Publishing country | Netherlands |
| Document type | Journal Article |
| ZDB-ID | 2211468-3 |
| ISSN | 1876-6250 ; 1568-5888 ; 0929-7456 |
| ISSN (online) | 1876-6250 |
| ISSN | 1568-5888 ; 0929-7456 |
| DOI | 10.1007/s12471-022-01701-y |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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