Safety and Feasibility of Performing Pericardiocentesis on Patients with Significant Pulmonary Hypertension^

摘要

Background/purpose: Pericardial effusion (PE) is a complication of pulmonary hypertension (PHT) and, specifically, pulmonary arterial hypertension (PAH), that confers a worse prognosis. The safety of performing pericardiocentesis in patients with PHT has not been established. We aimed to assess the safety and feasibility of performing pericardiocentesis in patients with significant PHT. Methods/materials: We performed a retrospective analysis from August 2013 to December 2018 at our tertiary-care center of patients who underwent a pericardiocentesis procedure. Patients, procedure, echocardiographic findings, any major intraprocedural complications, and post-procedural related complications up to 30 days were recorded. Specifically, we studied patients with significant PHT. Results: The cohort included 170 patients, with an average age of 62.6 years and an even distribution of gender and co-morbidities. The etiology for the PE varied. Major complications were rare (1.7%) and only 10 patients (5.9%) required re-intervention for reaccumulation of fluid. There were 27 patients (15.9%) with significant PHT, 5 with World Health Organization (WHO) Group I PAH (2.94%). In the entire cohort, there were only 3 major complications (1.7%), none among PHT patients. Conclusions: Pericardiocentesis is a safe procedure, including in patients with significant PHT, including those with WHO Group I PAH. We advocate the use of invasive hemodynamic monitoring in patients with significant PHT. Summary: Pericardiocentesis tends to be a safe procedure. However, the safety of performing pericardiocentesis in patients with significant pulmonary hypertension has not been well established. We aimed to assess the safety and feasibility of performing pericardiocentesis, and specifically in patients with significant PHT out our tertiary center by performing a retrospective analysis.