How is traditional pericardiocentesis performed for the diagnosis of acute pericarditis?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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The traditional approach is the subxiphoid technique. This technique avoids injury to the coronary arteries, as follows.

  • The chest is prepared with Betadine and a 16-gauge to 18-gauge needle is introduced between the xiphoid and the left subcostal margin.

  • The needle is directed toward the inferior tip of the left scapula with slow advancement and with aspiration.

  • If fluid is found, the needle is exchanged for a catheter over a guidewire. Fluid is removed via the catheter.

  • The catheter may be sutured in place for subsequent use. Alternatively, a 16-gauge to 18-gauge spinal needle may be used for one-time drainage.

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