Pericardiocentesis

The heart is surrounded by a double-layered sac called the pericardium. Between these two layers, there is a space known as the pericardial cavity. The pericardial cavity normally contains a small amount of pericardial fluid. This fluid prevents friction between the two layers and helps your heart move easier within the sac. If too much fluid accumulates between the pericardium and the heart itself, the condition is known as pericardial effusion. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased pressure which can negatively affect heart function. To alleviate such, a pericardiocentesis or pericardial window may be performed.

Pericardiocentesis is a non-invasive procedure (no incisions required / small puncture / low to moderate sedation) performed to remove fluid through the use of a needle and a small catheter.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

How to Prepare for the Procedure

Prior to the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Talk to your doctor about:

• All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
• Radiation exposure, especially for those that are pregnant.
• Any allergies to medicines, latex, tape, iodine, and anesthetic agents.
• Any history of bleeding disorders.
• Any body piercings on your chest or abdomen.

Other recommendations include:

• Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
• Leave all jewelry at home.
• Remove all makeup and nail polish.
• Wear comfortable clothing when you come to the hospital.
• If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

To determine whether you need this procedure, your doctor might perform a variety of diagnostic tests, including:

• Chest X-Rays
• Electrocardiogram (EKG/ECG)
• Blood tests
• Echocardiogram (ECHO)
• Computed Tomography (CT scan)
• Magnetic resonance imaging (MRI)
• Cardiac catheterization

What to Expect During the Procedure

A pericardiocentesis will typically take 30 minutes to 1 hour to complete. This procedure is typically performed in the catheterization lab. Check with your doctor about the details of your procedure. In general:

• You will change into a hospital gown.
• A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
• The doctor will apply a local anesthetic at the needle insertion site, below the breastbone.
• The needle will be guided to the fluid in the pericardial sac with the help of an echocardiogram or X-ray imaging (fluoroscopy).
• Once the needle is in the correct area, it will be removed and replaced with a catheter. Fluid will drain out through the catheter.
• The catheter will be removed when enough fluid has drained. Pressure will be applied to the catheter insertion site to prevent bleeding.
• The muscle and the skin incisions will be closed and a bandage applied.

What to Expect After the Procedure

After the surgery, you will stay at the hospital for 24 to 48 hours. Other recommendations include:

General Guidelines

• Your vital signs, such as your heart rate, breathing, blood pressure, and oxygen levels, will be closely monitored.
• You may feel some soreness, but you shouldn’t feel severe pain. Pain medications are available if needed.
• You will probably be able to drink the day after surgery. You can have regular foods as soon as you can tolerate them.
• Ambulation is started on the first or second day of surgery.
• You can probably do your normal activities after the surgery. But, you may need to take it easy at first. No heavy lifting or vigorous exercises until your body has healed.
• Your doctor will give you instructions to follow during your recovery.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.