Intentional Right Atrial Exit and Carbon Dioxide Insufflation to Facilitate Subxiphoid Needle Entry Into the Empty Pericardial Space: First Human Experience.

摘要: Abstract Objectives The purpose of this study was to test whether a microcatheter can safely be advanced across the right atrial appendage access pericardium and then withdrawn despite subsequent high-intensity anticoagulation. We also tested transatrial pericardial insufflation carbon dioxide (CO 2 ) would enhance safety subxiphoid needle empty by separating heart from anterior pericardium. Background Subxiphoid pericardium, required for left suture ligation epicardial ablation rhythm disorders, risks myocardial or coronary laceration. Methods A catheter femoral vein engaged angiographic confirmation position. Through that catheter, back end 0.014- 0.018-inch guidewire crossed wall enter delivered 2.4-F microcatheter. CO 1 ml/kg insufflated into immediately before under lateral projection fluoroscopy. Thirteen patients undergoing consented participate in research protocol. Results Right exit succeeded 11 subjects (85%) failed uneventfully subjects. 96 ± 22 ml achieved 12 4 mm separation wall, allowed rapid successful entry all subjects, did not have any evident hemodynamic effects. immediate aspirate serous but subject. Conclusions report first human intentional procedure. Transatrial safely. Pericardial with makes safe. Although our clinical experience date remains small, further experience, approach may prevent life-threatening complications “dry” access.