Poor outcomes associated with drainage of pericardial effusions in patients with pulmonary arterial hypertension
Poor outcomes associated with drainage of pericardial effusions in patients with pulmonary arterial hypertension
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DOI：
10.1097/smj.0b013e31816c0169
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发表时间：
2008-05-01
影响因子：
1.1
通讯作者：
Wiener, Charles M.
中科院分区：
文献类型：
--
作者：
Hemnes, Anna R.;Gaine, Sean P.;Wiener, Charles M.
目的：晚期肺动脉高压（PAH）常合并右心衰竭和心包积液。在这个group.Methods：在约翰霍普金斯医院PAH在1年期间，进行心包穿刺术或心包开窗术的最佳治疗大或血流动力学显着的心包积液尚未被定义。图表进行了分析，病人的特点，超声心动图数据，和类型/outcome of procedure.Results：6例患者被确定，5个进行治疗引流。在4例病例中进行了心包穿刺术; 2例有手术心包窗。2例患者在心包穿刺术后死亡，1例患者在手术后死亡。所有患者均在手术后13小时内死亡。结论：我们发现PAH患者的心包积液引流相关死亡率较高。这些死亡的病理生理学解释尚不清楚，但临床医生应考虑保守治疗，如果可能的话。
Objectives: Pulmonary arterial hypertension (PAH) in its advanced stages is complicated by right heart failure and often pericardial effusion. The optimal treatment of large or hemodynamically significant pericardial effusions in this group has not been defined.Methods: All patients followed at the Johns Hopkins Hospital for PAH during a 1-year period that underwent pericardiocentesis or pericardial window placement were identified. Charts were analyzed for patient characteristics, echocardiographic data, and type/outcome of procedure.Results: Six patients were identified; five under-went therapeutic drainage. Pericardiocentesis was performed in four cases; two had surgical pericardial windows. Two patients died after pericardiocentesis and one patient died after surgery. All patients died within 13 hours of the procedure.Conclusion: We found a high mortality related to pericardial fluid drainage in patients with PAH. The pathophysiologic explanation for these deaths remains unclear, but clinicians should consider conservative management in this situation if possible.