Pericardiocentesis Guided by Two-Dimensional Echocardiography.

Echodirected pericardiocentesis has become the method of choice for the initial treatment of clinically significant pericardial effusions since it was introduced into the regular practice at the Mayo Medical Center in April 1980. Between April 1980 and January 1, 1994, 610 consecutive two-dimensional (2-D) echodirected pericardiocenteses were performed at the Mayo Clinic. There have been no deaths in the series of consecutive cases. In the first 500 consecutive cases examined in detail, there were five serious complications and 18 nonthreatening complications. Echodirected pericardiocentesis is a safe, humane, and cost-effective means of performing a pericardial tap. Excellent results have been obtained even with a large number of physician operators. This technique is well suited to the primary care setting. Physicians performing this procedure should be familiar with reading and performing 2-D echocardiography. Qualified physicians can be trained, fairly easily, to perform echodirected pericardiocentesis.