This image showed tension pneumopericardium caused by removing the pericardiocentesis catheter, which was inserted to drain malignant pericardial effusion. Tension pneumopericardium is a rare and potentially fatal event. Mortality from tension pneumopericardium can be as high as 50%. Therefore, it is important to suspect and detect early, if the patient complained of dyspnea after removing the ...

Clinically significant pericardial effusion is an uncommon complication after cardiac surgery. Pericardiocentesis can be performed either through a mini-sternotomy or under echocardiography guidance. Echocardiography guidance is a relatively safe procedure and it avoids the need for another general anaesthetic. However, in this post cardiac surgical patient echocardiography guided pericardiocen...

Emergency pericardiocentesis done for hemodynamically significant cardiac tamponad is associated with rare but life-threatening complications including chamber perforation. Echocardiography the usual tool to diagnose procedural of pericardiocentesis. We are reporting a case attempted where apparent perforation by saline contrast echo turned out be an inconsequential hepatic vein puncture.

We thank Drs Tsang and Seward for their interesting comments. The Mayo Clinic’s important experience in echoguided pericardiocentesis was cited in our paper. However, the approach we described is technically different. In Europe, the Marfan’s approach, or subxiphoid puncture proposed by Marfan, is routinely used in cardiac tamponade, in which a swinging heart is frequently present. The most com...