Interventional Pericardiology - Pericardiocentesis and Intrapericardial Treatment - Current Indications, Techniques, Therapeutic Value, and Future Perspective

DESCRIZIONE

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.Table of contents Foreword Preface Acknowledgments Authors 1. A Historical Perspective 1.1. Introduction 1.2. Diagnostic and therapeutic pericardial interventions 1.2.1. Pericardiocentesis and pericardial drainage 1.2.2. Pericardioscopy 1.2.3. Pericardial biopsy 1.2.4. Percutaneous balloon pericardiotomy 1.2.5. Intrapericardial treatment of pericardial disease 1.2.6. Intrapericardial treatment of non-pericardial disease 1.3. Future perspectives and recommendations 2. Anatomy of the Pericardium Relevant for Pericardial Access, Pericardioscopy, and Intrapericardial Interventions 2.1. Introduction 2.2. Structures of the normal pericardium 2.2.1. Pericardial sinuses and recesses 2.2.2. Epicardial and pericardial fat 2.2.3. Normal pericardial fluid 2.2.4. Nerves, arteries, lymphatics, and lymph nodes 2.3. Pericardial anomalies 2.4. Distinction between the human and animal pericardium 2.5. Future perspectives and recommendations 3. Pericardial Effusion and Cardiac Tamponade 3.1. Introduction 3.2. Clinical presentation of cardiac tamponade 3.3. Physical findings in cardiac tamponade 3.3.1. Pulsus paradoxus 3.4. Electrocardiogram in cardiac tamponade 3.5. Chest radiography 3.6. Echocardiography 3.7. Cardiac catheterization and invasive hemodynamics 3.8. Medical management of cardiac tamponade 3.9. Future perspectives and recommendations 4. Pericardial Access and Drainage: Standard Techniques 4.1. Introduction 4.2. Indications for pericardial drainage 4.3. Emergency pericardiocentesis 4.4. Echocardiography-guided pericardiocentesis 4.4.1. Evolution of echo-guided pericardiocentesis 4.4.2. Safety and efficacy of echo-guided pericardiocentesis 4.4.3. Reduction of effusion recurrence with catheter drainage 4.4.4. Technique of state-of–the-art echo-guided pericardiocentesis 4.5. Pericardiocentesis guided by fluoroscopy 4.5.1. Feasibility of fluroscopy guided pericardiocentesis 4.5.2. The role of cardiac catheterization during pericardiocentesis 4.5.3. Safety of fluoroscopy guided pericardiocentesis 4.6. Surgical drainage of the pericardium 4.7. Future perspectives and recommendations 5. Alternative Techniques for Pericardiocentesis 5.1. Introduction 5.2. Pericardiocentesis guided by epicardial halo phenomenon 5.2.1. Physical origin of the sign 5.2.2. Tangential approach to the pericardial surface 5.2.3. Feasibility and safety 5.2.4. Clinical implications 5.3. PerDUCER® technique 5.3.1. Endoscopic guidance in patients with perimyocarditis 5.3.2. PerDUCER® procedure in patients with moderate/large effusions 5.3.3. Potential improvements of the procedure 5.4. PeriAttacher® and AttachGuider® 5.5. Pericardial access using a blunt-tip needle 5.6. Transbronchial approach 5.7. Computer guided pericardiocentesis 5.8. Pericardiocentesis guided by computed tomography 5.9. Pericardiocentesis guided by a pacing capture 5.10. Future perspectives and recommendations 6. Pericardiocentesis in the Absence of Effusion 6.1. Introduction 6.2. Subxiphoid pericardiocentesis using a Tuohy needle and fluoroscopy 6.2.1. Technique and potential complications 6.2.2. Feasibility and safety 6.2.3. Limitations of the approach 6.3. The PerDUCER® technique 6.3.1. Experimental experience 6.3.2. Access of the human pericardium in the absence of effusion using PerDUCER 6.4. Pericardial access via trans-atrial approach 6.4.1. Catheter system with a pre-mounted needle 6.4.2. Streamlined catheter system 6.4.3. Safety of the transatrial approach 6.4.4. Study limitations 6.4.5. Clinical implications 6.5. Right ventricular approach 6.6. Future perspectives and recommendations 7. Diagnostic Value of Pericardial Fluid Analyses 7.1. Introduction 7.2. Volume and appearance of pericardial effusion 7.3. Pericardial fluid cytology 7.3.1. Number of specimens needed for pericardial fluid cytology 7.3.2. Detection of malignancy by pericardial fluid cytology 7.3.3. Reactive mesothelial vs. adenocarcinoma cells 7.3.4. Prognostic and therapeutic implications 7.3.5. Paramalignant pericardial effusion 7.3.6. Blood cells in pericardial effusion 7.3.7. Staining for bacteria in pericardial effusion 7.4. Biochemical analyses 7.4.1. Differentiation of transudates and exudates 7.4.2. Pericardial cytokines 7.4.3. Adenosine deaminase activity in pericardial effusion 7.5. Virology of pericardial effusion 7.5.1. Polymerase chain reaction – PCR 7.6. Bacteriology of pericardial effusion 7.6.1. Bacteriology of pericardial effusion in tuberculous pericarditis 7.6.2. Bacteriology of pericardial effusion in patients with AIDS 7.7. Tumor markers 7.7.1. Carcinoembryonic antigen – CEA 7.7.2. Neuron-specific enolase – NSE 7.7.3. Carbohydrate antigen 125 – CA125 7.7.4. Alpha-fetoprotein 7.8. Immunology of pericardial effusion 7.8.1. Serodiagnosis of tuberculous pericarditis 7.9. Future perspectives and recommendations 8. Pericardioscopy: Endoscopic Insight into Pericardial Pathology 8.1. Introduction 8.2. Technical considerations 8.3. Analysis of diagnostic value 8.4. Feasibility and safety 8.5. Future perspectives and recommendations 9. Epicardial and Pericardial Biopsy 9.1. Introduction 9.2. Technique 9.2.1. Pericardial biopsy guided by fluoroscopy 9.2.2. Pericardial and epicardial biopsy targeted by pericardioscopy 9.3. Sampling efficiency and histological findings 9.4. Sensitivity of pericardial biopsy: a key issue for the successful clinical application 9.5. Diagnostic value 9.6. The analyses of the epicardial and pericardial biopsy samples 9.6.1. Processing techniques 9.6.2. Molecular biology techniques 9.6.3. Immunohistochemistry of epicardial biopsies 9.7. Safety and complications 9.8. Future perspectives and recommendations 10. Intrapericardial Treatment of Pericardial Disease 10.1. Introduction 10.2. Intrapericardial treatment of neoplastic pericarditis 10.2.1. Cisplatin 10.2.2. Thiotepa 10.2.3. Alternative agents 10.3. Intrapericardial treatment of autoreactive pericarditis 10.4. Intrapericardial treatment of uremic pericarditis 10.5. Intrapericardial treatment of purulent pericarditis 10.6. Future perspectives and recommendations 11. Percutaneous Balloon Pericardiotomy 11.1. Introduction 11.2. Indications and contraindications 11.3. Methodological considerations 11.4. Mechanism of action 11.5. Balloon catheter selection 11.6. Multicenter analysis of feasibility and long-term results 11.7. Safety 11.8. Future perspectives and recommendations 12. Frontiers and Emerging Procedures 12.1. Introduction 12.2. Intrapericardial echocardiography 12.3. Intrapericardial treatment of non-pericardial diseases 12.3.1. Potential advantages of intrapericardial approach 12.3.2. Possible drawbacks of intrapericardial pharmacokinetics 12.3.3. Intrapericardial application of coronary vasodilators 12.3.4. Intrapericardial anti-arrhythmic therapy 12.3.5. Intrapericardial prevention of restenosis 12.3.6. Intrapericardial gene therapy 12.3.7. Intrapericardial application of growth factors 12.3.8. Intrapericardial application of stem cells 12.3.9. Intrapericardial treatment of ventricular rupture 12.4. Ambulatory pericardial drainage using a permanent port system 12.5. The Heart-Lander® – intrapericardial crawling robotic device 12.6. Epicardial mapping and radiofrequent ablation 12.7. Future perspectives and recommendations INDEX

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ISBN: 9783642113345

Titolo: Interventional Pericardiology - Pericardiocentesis and Intrapericardial Treatment - Current Indications, Techniques, Therapeutic Value, and Future Perspective

Autori: Maisch

Editore: Springer Verlag

Volume: Unico

Edizione: 2010

Lingua: Inglese

Finitura: Copertina flessibile

Pagine: 200

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