1/15. Successful use of thoracoscopic pericardiectomy in elderly patients with massive pericardial effusion caused by uremic pericarditis.We report the use of thoracoscopic pericardiectomy to treat two elderly patients with massive pericardial effusion caused by uremic pericarditis. A 79-year-old man, admitted to our hospital complaining of dyspnea, was diagnosed with end-stage renal failure and began maintenance hemodialysis. Although intensive hemodialysis was performed, the patient could not remain on hemodialysis because of severe hypotension during the procedure. echocardiography revealed massive pericardial effusion and severe hypokinesis of the left ventricular wall. pericardiocentesis was performed first, without success, followed by thoracoscopic pericardiectomy under general anesthesia. One month after the pericardiectomy, episodes of hypotension during hemodialysis improved, and dyspnea diminished. echocardiography showed no pericardial effusion and improvement of left ventricular wall motion. pericarditis is a fatal complication in patients with end-stage renal failure and patients on maintenance hemodialysis. The second patient received the same procedure with a similar improvement of clinical symptoms. These cases suggest that thoracoscopic pericardiectomy is a safe and effective treatment of pericardial effusion caused by uremic pericarditis in elderly patients on hemodialysis.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/15. diagnosis and successful surgical treatment of chronic constrictive uraemic pericarditis.A case of chronic constrictive uraemic pericarditis successfully treated by pericardectomy is reported together with the pre- and postoperative haemodynamic data.- - - - - - - - - - ranking = 0.83333333333333keywords = pericarditis (Clic here for more details about this article) |
3/15. Uremic pericarditis as a cause of cardiac tamponade.Uremic pericarditis may complicate either acute or, more commonly, chronic renal failure. When dialysis is not employed, uremic pericarditis is usually a preterminal event and is characterized by a serofibrinous exudation of an amount inadequate to cause cardiac tamponade. Nevertheless, cardiac tamponade may uncommonly be observed in nondialyzed patients. cardiac tamponade, which may be life-threatening, is more common in dialyzed than in nondialyzed patients with chronic renal failure. The primary causes of cardiac tamponade in uremic pericarditis in order of decreasing frequency are (1) pericardial effusion, usually of the serosanguineous type, (2) massive hemorrhage into the pericardial sac and (3) collagenization of pericardial exudate. From pathologic evidence, the following forms of therapy appear appropriate to manage uremic pericarditis that has reached the stage of causing cardiac tamponade. For effusion, pericardiocentesis or parietal pericardiectomy are logical procedures. Massive hemorrhage into the pericardial sac is usually attended by clotting and requires pericardiotomy and evacuation of clot. Collagenization of exudate yields an encasing, fibrous shell over the heart and requires decortication, as is practised in classical constrictive pericarditis.- - - - - - - - - - ranking = 1.5keywords = pericarditis (Clic here for more details about this article) |
4/15. Hemorrhagic cardiac tamponade in critically ill patients with acute renal failure.PURPOSE: The purpose of this study was to report the development, management, and follow up of tamponading uremic pericardial effusion in critically ill patients with acute renal failure. SETTING: The setting for this study was an adult, 24-bed tertiary multidisciplinary intensive care unit (ICU) of a university hospital. patients: The subjects were 5 critically ill patients with multiple organ failure including acute renal failure (ARF) that was slow to resolve. RESULTS: Renal involvement was attributed to renal hypoperfusion, sepsis and myoglobinuria. Continuous veno-venous hemofiltration (CVVH) was instituted early during hospitalization in 4 cases and lasted for 35 to 48 days; renal replacement therapy was not used in 1 case. Tamponade developed late in the course of ARF, after CVVH was discontinued in the 4 cases and was effectively managed with percutaneous pericardiocentesis under echocardiography and continuous catheter drainage of the pericardial sac for 48 to 72 hours. Hemorrhagic fluid (Hb 2.2-5.9 g/dL) with lymphocyte predominance was detected. Transient constrictive-like pericarditis findings were present in all patients after the procedure. All patients were discharged from the hospital in a good condition with normal serum and creatinine levels; 1-year follow up showed a normal echocardiogram. CONCLUSION: awareness for the possibility of hemorrhagic pericarditis and cardiac tamponade is needed in ICU patients with ARF slow to resolve. Transient constrictive-like pericarditis may present after pericardiocentesis.- - - - - - - - - - ranking = 0.5keywords = pericarditis (Clic here for more details about this article) |
5/15. Intrapericardial triamcinolone hexacetonide in the treatment of intractable uremic pericarditis in a child.Uremic pericarditis in children on chronic hemodialysis represents a difficult management problem, necessitating vigorous medical therapy and often surgical drainage of the pericardial effusion. Standard therapeutic approaches have met with limited success. The successful use of intrapericardial triamcinolone in a 10-year anephric boy on chronic dialysis is reported and accompanied by a description of the technique applied and literature review.- - - - - - - - - - ranking = 0.83333333333333keywords = pericarditis (Clic here for more details about this article) |
6/15. Uraemic pericarditis, an epidemic disease?pericarditis (PC) is a frequent complication with renal failure. Numerous causes have been proposed. Over a six week period, we observed five cases of PC in five of 102 patients on maintenance haemodialysis. Viral cause was suspected in one case (Respiratory Syncytial Virus). During the past year, no recurrence of PC has been seen. The case clustering episodes might suggest a viral cause. The value of examining the patients by stetoscopy and echocardiography was documented.- - - - - - - - - - ranking = 0.66666666666667keywords = pericarditis (Clic here for more details about this article) |
7/15. Iatrogenic arteriovenous fistula. An unusual complication of indwelling pericardial catheter and intrapericardial steroid instillation for the treatment of uremic pericarditis.The drainage and instillation of poorly absorbable corticosteroids has recently been suggested as an laternative to the present modes of therapy for uremic pericarditis. One patient who underwent such a therapeutic approach subsequently had a left internal mammary artery to right internal mammary vein arteriovenous fistula develop. To our knowledge, this is the first report of the development of arteriovenous fistula after either pericardiocentesis or intrapericardial instillation of steroids.- - - - - - - - - - ranking = 0.83333333333333keywords = pericarditis (Clic here for more details about this article) |
8/15. Treatment of uremic pericarditis and pericardial effusion by augmented hemodialysis.Six out of 21 patients attending maintenance hemodialysis had uremic pericarditis. Three patients had one or more recurrences of pericarditis while under regular intermittent dialysis. Two patients developed pericardial effusion and one of them had ascites. Augmented hemodialysis was successful in treating uremic pericarditis even in patients with pericardial effusion. The single instance of ascites was also controlled by augmented hemodialysis.- - - - - - - - - - ranking = 1.1666666666667keywords = pericarditis (Clic here for more details about this article) |
9/15. infection complicating intrapericardial steroid instillation in uremic pericarditis.Short-term, indwelling, percutaneous pericardiocentesis for drainage with local steroid instillation has been advocated for refractive uremic pericarditis. It is reported to be almost universally successful and to cause only minor complications. We describe a patient in whom this technique lead to purulent pericarditis (staphylococcus aureus) requiring pericardiectomy.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
10/15. Hepatic friction rub in uremia.Hepatic friction rubs developed in two patients undergoing maintenance hemodialysis. Thorough evaluation, including autopsy in one patient, did not demonstrate any known cause for the rubs except that uremic pericarditis had complicated the course of both patients and one suffered from chronic hemolytic anemia. The clinical course suggests that hepatic friction rubs may be associated with either uremia or maintenance hemodialysis.- - - - - - - - - - ranking = 0.16666666666667keywords = pericarditis (Clic here for more details about this article) |
| | Next -> |