1/11. cardiac tamponade following acupuncture.We present a rare complication of acupuncture in a 83-year-old woman who developed syncope and cardiogenic shock shortly after an acupuncture procedure into the sternum. echocardiography revealed cardiac tamponade, and pericardiocentesis disclosed hemopericardium. Due to hemodynamic instability, thoracotomy was indicated. A small but actively bleeding perforation of the right ventricle was found and successfully closed. Although acupuncture represents a relatively safe therapeutic intervention, this case report should remind all acupuncturists of possible and sometimes life-threatening adverse effects.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/11. cardiac tamponade following sternal puncture in two patients.Sternal puncture for harvesting bone marrow is a procedure with potentially lethal complications. Both the occurrence of pneumothorax and sternal fracture are reported. We present two patients with a cardiac tamponade following elective sternal puncture. (See editorial p. 4).- - - - - - - - - - ranking = 0.85714285714286keywords = puncture (Clic here for more details about this article) |
3/11. Transcardiac pericardiocentesis: an emergency life-saving technique for cardiac tamponade.life-threatening cardiac tamponade is one of the most serious complications of catheter-based cardiac procedures. Although most cases can be effectively treated by percutaneous pericardiocentesis, urgent surgical drainage is required in unsuccessful cases. Rarely, in collapsed patients, the delay for surgery, however minimal, may be fatal. We describe a technique whereby life-saving pericardial drainage was rapidly achieved via a novel transcardiac approach, using the transseptal puncture kit, after failure of conventional pericardiocentesis in a patient with procedure-related acute tamponade who rapidly deteriorated and developed cardiorespiratory arrest within a few minutes. Although surgical repair for the perforation had to be performed subsequently, the patient survived without sequelae. This transcardiac approach may be an important and potentially life-saving adjunctive technique after failure of conventional pericardiocentesis in rapidly deteriorating or extremely unstable patients.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
4/11. Complications of transvenous right ventricular endomyocardial biopsy in adult patients with cardiomyopathy: a seven-year survey of 546 consecutive diagnostic procedures in a tertiary referral center.To determine the incidence, nature and subsequent management of complications occurring during right ventricular endomyocardial biopsy in patients with cardiomyopathy, all events occurring during 546 procedures in 464 consecutive patients were prospectively recorded. The internal jugular vein was the primary site of introduction in 96% of cases. A total of 33 complications (6%) occurred: 15 (2.7%) during catheter insertion including 12 arterial punctures (2%), 2 vasovagal reactions (0.4%) and 1 episode of prolonged bleeding (0.2%), all without sequelae; 18 (3.3%) during biopsy included 6 arrhythmias (1.1%), 5 conduction abnormalities (1%), 4 possible perforations (0.7%) and 3 definite perforations (0.5%) (pericardial fluid). Two (0.4%) of the three patients with a perforation died. There was no secular trend in the complication rate, nor were complications associated with specific clinical or hemodynamic characteristics. It is concluded that the overall rate of endomyocardial biopsy complications (6%) is low, but mortality may occur.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
5/11. Delayed cardiac tamponade and hemothorax induced by an acupuncture needle.We report a 52-year-old man who presented with cardiac tamponade a few years after accidental breakage of an acupuncture needle that had not been removed. thoracotomy showed a hemopericardium with penetration of the pulmonary artery by the very fine needle which was barely detected on the chest roentgenogram. This lesion was not suspected on the basis of roentgenography, two-dimensional echocardiography, or computed tomography, but was detected by the presence of other thick needles in the neck, chest and abdomen. This case showed a possible threat of 'stealthy' and migrating foreign bodies, such as very fine acupuncture needles.- - - - - - - - - - ranking = 0.85714285714286keywords = puncture (Clic here for more details about this article) |
6/11. Late cardiac tamponade following open-heart surgery. Diagnosis and treatment.Late cardiac tamponade is a rare but serious complication following open-heart surgery. It occurred in 9 (0.8%) of 1 094 consecutive patients 6 to 13 (median 8) days after operation. Six patients had undergone valve replacement and three coronary bypass surgery. All were on anticoagulant medication postoperatively (median TT index 7%). Early symptoms of cardiac tamponade were nausea and general malaise (present in all 9 cases), whereas classical signs of tamponade such as arterial hypotension and distended neck veins appeared late. The cardiac silhouette was radiographically enlarged in all cases, but this finding was seldom diagnostic. Computed tomography gave the surest diagnosis and permitted quantitative assessment of the fluid in the pericardium. Pericardial needle puncture was effective in temporarily relieving the tamponade, but insertion of a tube by the subxiphoid approach gave definitive drainage.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
7/11. cardiac tamponade: pericardiocentesis directed by two-dimensional echocardiography.Symptomatic pericardial effusion has been recognized as a diagnostic and therapeutic problem for many centuries. Although surgical incision and blind needle puncture of the pericardium for removal of the fluid have been available for somewhat more than 150 years, both procedures are associated with serious complications. echocardiography provides a unique means of diagnosing and managing pericardial effusion. The two-dimensional echocardiographic beam demonstrates the presence of the pericardial effusion and locates an ideal entry point and track for the needle used in pericardiocentesis. At our institution, echocardiography-directed pericardiocentesis has been the procedure of choice for cardiac tamponade for the past 4 years, during which time 132 consecutive pericardial taps have been performed. Our experience has shown that this is a safe, effective technique that can be used by a physician who is familiar with two-dimensional echocardiography. We recommend its wide acceptance and use.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
8/11. cardiac tamponade in an infant. A rare complication of central venous catheterisation.A 2994 g infant suffered cardiac tamponade from an infusion of total parenteral nutrition through an indwelling central venous catheter. The infant survived as a result of early diagnosis and aggressive therapeutic intervention. cardiac tamponade secondary to central venous catheterisation is rare, but potentially lethal. Possible mechanisms are direct puncture by the catheter tip, or osmotic injury from the use of hypertonic solutions. To avoid this complication, the catheter tip should be prevented from entering the right atrium and its position should be checked periodically by chest X ray. cardiac tamponade should be considered in any patient with a central venous catheter whose clinical condition deteriorates suddenly. Diagnostic or therapeutic pericardiocentesis should be employed as the first measure and time should not be wasted on other diagnostic procedures.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
9/11. Iatrogenic cardiac tamponade during pregnancy.A 26-year-old primigravida who presented to us with threatened preterm labour which was suppressed successfully with sulindac, was found to have a pericardial effusion. pericardiocentesis was performed because of evidence of right ventricular compression. However, it was complicated by inadvertent puncture of the left ventricle causing cardiac tamponade, and hypovolaemic shock shortly afterwards. An emergency pericardiotomy was performed to rescue the patient.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
10/11. An unusual cause of penetrating cardiac injury in a child.The authors report on a 7-year-old boy who suffered an unintentional penetrating cardiac injury while misusing a lawn toy in a predictable way. The boy was hemodynamically stable, with abdominal pain and tenderness. The pericardial effusion was first noted on upper abdominal computerized tomographic images and was confirmed by echocardiography. A puncture wound of the anterior right ventricle was found. As in this case, children may not have the typical signs and symptoms of cardiac tamponade, making the diagnosis difficult and delaying appropriate care. This child's injury could have been prevented through increased parental supervision or a modified toy design that takes into account predictable patterns of misuse.- - - - - - - - - - ranking = 0.14285714285714keywords = puncture (Clic here for more details about this article) |
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