Interventional Pericardiology : Pericardiocentesis, Pericardioscopy, Pericardial Biopsy, Balloon Pericardiotomy, and Intrapericardial Therapy

Interventional Pericardiology gives a unique and comprehensive view on an often neglected but clinically very important part of cardiovascular disease: The pericardium and the adjacent myocardium or epicardium. The authors of this up-to-date compendium on pericardial disease etiology, diagnostics and treatment, Professors Bernhard Maisch (Marburg), Arsen Ristić (Belgrade), Petar Seferović (Belgrade) and Teresa Tsang (Rochester) focus on recent advances to the new window that has been opened to the heart by flexible and video-assisted pericardioscopy, modern biochemical, immunohistological and molecular tools for the analysis of epicardial and pericardial biopsies, which have been acquired safely under pericardioscopic control by the interventional pericardiologist. Their book adds brand-new information to the recent and so far only guidelines world-wide by the European Society of Cardiology on the management of pericardial diseases. This task-force has been chaired by the lead author B. Maisch. Accordingly “Interventional Pericardiology” belongs in every medical library and on the desk of every cardiologist, cardiological interventionalist, and trainee with an interest in pericardial diseases. Cover......Page 1 Interventional Pericardiology......Page 4 ISBN 9783642113345......Page 5 Foreword......Page 6 Foreword......Page 8 Preface......Page 10 Acknowledgment......Page 12 Co-Authors......Page 14 Content......Page 16 Accompanying DVD......Page 22 Introduction......Page 24 Pericardiocentesis and Pericardial Drainage......Page 25 Direct, Surgical Approach to PericardialDrainage......Page 26 Advances Through the Developmentof Technology......Page 27 Pericardioscopy......Page 28 Pericardial Biopsy......Page 29 Percutaneous Balloon Pericardiotomy......Page 30 Intrapericardial Treatment of Non-PericardialDisease......Page 31 References......Page 32 Pericardial Sinuses and Recesses......Page 38 Epicardial and Pericardial Fat......Page 40 Pericardial Anomalies......Page 41 References......Page 42 Introduction......Page 44 Physical Findings in Cardiac Tamponade......Page 45 Electrocardiogram in Cardiac Tamponade......Page 46 Echocardiography......Page 48 Computed Tomography and MagneticResonance Imaging......Page 51 Cardiac Catheterization and InvasiveHemodynamics......Page 52 References......Page 53 Indications for Pericardial Drainage......Page 56 Emergency Pericardiocentesis......Page 58 Evolution of Echo-Guided Pericardiocentesis......Page 60 Technique of State-of-the-Art Echo-GuidedPericardiocentesis......Page 61 Selection of the Ideal Entry Site......Page 62 Saline Echo-Contrast for Confirmationof Position......Page 63 Intermittent Catheter Drainageand Maintenance......Page 64 Pericardiocentesis Guided by Fluoroscopy......Page 65 Feasibility of Fluoroscopy-GuidedPericardiocentesis......Page 68 The Role of Cardiac Catheterization DuringPericardiocentesis......Page 69 Safety of Fluoroscopy-GuidedPericardiocentesis......Page 71 Surgical Drainage of the Pericardium......Page 72 References......Page 74 Pericardiocentesis Guided by EpicardialHalo Phenomenon......Page 78 Tangential Approach to the PericardialSurface......Page 79 Feasibility and Safety of PericardiocentesisGuided by the Epicardial Halo Phenomenon......Page 80 Pericardial Effusion Access Using PerDUCER®Device......Page 81 Endoscopic Guidance in Patientswith Perimyocarditis......Page 82 Potential Improvements of the Procedure......Page 83 The PeriAttacher for Accessingthe Pericardial Space......Page 84 The AttachGuider for the Guidanceof Instruments in Cavities, in Particularthe Pericardial Space......Page 86 Pericardial Access Using a Blunt-Tip Needle......Page 88 Transbronchial Approach......Page 89 Decision......Page 90 Feasibility of the Computer-GuidedPericardiocentesis......Page 91 Pericardiocentesis Guided by ComputedTomography......Page 92 CT-Fluoroscopy......Page 93 Technique......Page 94 Reference......Page 97 Technique and Potential Complications......Page 100 Feasibility and Safety......Page 101 Experimental Experience......Page 102 Access of the Human Pericardium in theAbsence of Effusion Using PerDUCER®......Page 103 Catheter System with a Pre-Mounted Needle......Page 104 Streamlined Catheter System......Page 105 Clinical Implications......Page 106 Right Ventricular Approach......Page 107 References......Page 108 Volume and Appearance of PericardialEffusion......Page 110 Detection of Malignancy by Pericardial FluidCytology......Page 111 Prognostic and Therapeutic Implications......Page 113 Staining for Bacteria in Pericardial Effusion......Page 114 Differentiation of Transudates and Exudates......Page 115 Pericardial Cytokines......Page 116 Adenosine Deaminase Activity in PericardialEffusion......Page 119 Virology of Pericardial Fluid......Page 120 Viral DNA/RNA Extraction......Page 121 Bacteriology of Pericardial Effusion......Page 122 Bacteriology of Pericardial Effusionin Tuberculous Pericarditis......Page 123 Bacteriology of Pericardial Effusionin Patients with AIDS......Page 124 Carbohydrate Antigen 125 (CA125)......Page 125 Immunology of the Pericardial Fluid......Page 126 References......Page 128 Selection of the Endoscope......Page 134 Rigid Instruments......Page 136 Flexible Pericardioscopy......Page 137 Pericardioscopic Appearance of VariousPericardial Pathologies......Page 138 Analyses of Diagnostic Value......Page 139 Future Perspectives and Recommendations......Page 141 References......Page 143 Pericardial Biopsy Guided by Fluoroscopy......Page 146 Pericardial and Epicardial Biopsy Targetedby Pericardioscopy......Page 147 Sampling Efficiency and HistologicalFindings......Page 148 Sensitivity of Pericardial Biopsy: a KeyIssue for the Successful Clinical Application......Page 149 Diagnostic Value......Page 150 Safety and Complications......Page 154 Future Perspectives and Recommendations......Page 155 References......Page 156 Intrapericardial Treatment of NeoplasticPericarditis......Page 158 Cisplatin......Page 160 Thiotepa......Page 162 Intrapericardial Treatment with AntitumorAntibiotics (Bleomycin, Mitomycin C,Aclarubicin)......Page 163 Intrapericardial Instillation of Tetracycline,Oxytetracycline, and Minocycline......Page 164 Intrapericardial Treatment with OK-432......Page 166 Intrapericardial Treatment of AutoreactivePericarditis......Page 167 Intrapericardial Treatment of PurulentPericarditis......Page 170 Future Perspectives and Recommendations......Page 172 References......Page 173 Indications and Contraindications......Page 178 Mechanism of Action......Page 180 Balloon Catheter Selection......Page 181 Analysis of Feasibility and Long-TermResults......Page 182 References......Page 183 Introduction......Page 186 Intrapericardial Echocardiography......Page 187 Possible Drawbacks of IntrapericardialPharmacokinetics......Page 188 Intrapericardial Application of CoronaryVasodilators......Page 189 Beta-Blocking Agents......Page 190 Intrapericardial Prevention of Restenosis......Page 191 Intrapericardial Application of GrowthFactors......Page 192 Intrapericardial Application of Stem Cells......Page 193 Ambulatory Pericardial Drainage Usinga Permanent Port System......Page 194 Epicardial Mapping and RadiofrequencyAblation......Page 195 Future Perspectives and Recommendations......Page 197 Subject Index......Page 202 Interventional Pericardiology gives a unique and comprehensive view on an often neglected but clinically very important part of cardiovascular disease: The pericardium and the adjacent myocardium or epicardium. The authors of this up-to-date compendium on pericardial disease etiology, diagnostics and treatment, Professors Bernhard Maisch (Marburg), Arsen Ristic (Belgrade), Petar Seferovic (Belgrade) and Teresa Tsang (Rochester) focus on recent advances to the new window that has been opened to the heart by flexible and video-assisted pericardioscopy, modern biochemical, immunohistological and molecular tools for the analysis of epicardial and pericardial biopsies, which have been acquired safely under pericardioscopic control by the interventional pericardiologist. Their book adds brand-new information to the recent and so far only guidelines world-wide by the European Society of Cardiology on the management of pericardial diseases. This task-force has been chaired by the lead author B. Maisch. Accordingly “Interventional Pericardiology” belongs in every medical library and on the desk of every cardiologist, cardiological interventionalist, and trainee with an interest in pericardial diseases.