What is the role of emergency subxiphoid percutaneous drainage in the treatment of cardiac tamponade?

Updated: Nov 28, 2018
  • Author: Chakri Yarlagadda, MD, FACC, FSCAI, FASNC, CCDS; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

This is a life-saving bedside procedure. The subxiphoid approach is extrapleural; hence, it is the safest for pericardiocentesis performed without echocardiographic guidance. A 16- or 18-gauge needle is inserted at an angle of 30-45° to the skin, near the left xiphocostal angle, aiming towards the left shoulder. When performed emergently, this procedure is associated with a reported mortality rate of approximately 4% and a complication rate of 17%.


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