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(Chest. 2003;123:1753-1758.)
© 2003 American College of Chest Physicians

A New Diagnostic and Therapeutic Approach to Pericardial Effusion*

Transbronchial Needle Aspiration

Loris Ceron, MD; Massimo Manzato, MD; Franco Mazzaro, MD and Federico Bellavere, MD

* From the Department of Internal Medicine, Villa Salus General Hospital, Venice, Italy.

Correspondence to: Loris Ceron, MD, Medicina Generale Ospedale Villa Salus, Via Terraglio, 114-30174 Mestre-Venice, Italy; e-mail: lorceron{at}tin.it

Pericardiocentesis was introduced during the 19th century, and reached its current level of development with the introduction of two-dimensional echocardiography. Although there is general agreement that complications are rare with skilled operators, a diagnostic and therapeutic problem often occurs when there is a posterior pericardial effusion, as it is not easy to quantify by echocardiography, and difficult to drain through a percutaneous access; therefore, it is usually treated surgically. We describe a new approach to pericardial effusion by a transbronchial access through the left lower lobe bronchus (which allows both diagnosis and evacuation of abundant amounts of fluid), or through the distal trachea (for diagnostic purpose only, in the presence of pericardial effusions filling the aortic recess of the pericardium). The technique is rather easy for operators skilled in transbronchial needle aspiration, and is safe, economical, and well tolerated.

Key Words: aortic recess of the pericardium • pericardial effusion • transbronchial needle aspiration






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