Successful Computed Tomography-guided Pericardiocentesis after Performing a Failed Conventional Transthoracic Echocardiography-guided Approach: A Case Report

• Published in: Journal of emergency medicine case reports 2020-10, Vol.11 (2), p.39-42
• Main Authors: Hongo, Takashi, Sugiyama, Hiroki, Naito, Hiromichi, Nakao, Atsunori
• Format: Article
• Language: English
• ISSN: 2149-9934; 2149-9934
• DOI: 10.33706/jemcr.632857

Introduction: Computed tomography-guided pericardiocentesis has been shown to be technically feasible and safe for treating pericardial effusion. However, no recommendations for computed tomography-guided pericardiocentesis have been made and standardized among the established guidelines by the European Society of Cardiology or the Japanese Circulation Society. We report on a case of successful computed tomography-guided pericardiocentesis after performing a failed conventional transthoracic echocardiography-guided approach in a patient with cardiac tamponade.Case Report: A 71-year-old man was admitted to our hospital with progressive chest discomfort and cardiac tamponade. Transthoracic echocardiography-guided pericardiocentesis was primarily performed on the patient; however, the quality of the transthoracic echocardiography images was inadequate to guide the procedure, resulting in procedure-related pericardial injury. When cardiac tamponade recurred, a computed tomography-guided approach successfully treated the patient, with the success owed to precise intraoperative visualization of the needle and organs.Conclusion: Our case suggests that computed tomography guidance is safe and useful in pericardiocentesis, especially for patients who are ineligible to undergo an echo-guided approach.