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Treatment for purulent pericarditis consists of two main components. [3] Antimicrobial therapy. Empiric intravenous antimicrobial therapy is recommended as soon as a diagnosis of purulent pericarditis is suspected. [3] Pericardial drainage. There are several therapeutic mechanisms that can be used to drain purulent fluid from the pericardial sac.
Pulmonary artery agenesis refers to a rare congenital absence of pulmonary artery due to a malformation in the sixth aortic arch. It can occur bilaterally, with both left and right pulmonary arteries being absent, or unilaterally, the absence of either left or right pulmonary artery (UAPA).
Pericardiectomy is the surgical removal of part or most of the pericardium. [1] [2] This operation is most commonly used to relieve constrictive pericarditis, or to remove a pericardium that is calcified and fibrous. [2] It may also be used for severe or recurrent cases of pericardial effusion. [3]
Surgical removal of the pericardium, pericardiectomy, may be used in severe cases and where the pericarditis is causing constriction, impairing cardiac function. It is less effective if the pericarditis is a consequence of trauma, in elderly patients, and if the procedure is done incompletely.
A catheter is often left in the pericardium to continue draining any remaining fluid after the initial procedure. [7] The catheter can be removed when the hemopericardium no longer persists. The underlying causes of the condition, such as over-prescription of anticoagulants , must be addressed as well so that the hemopericardium does not return.
The definitive treatment for constrictive pericarditis is pericardial stripping, which is a surgical procedure where the entire pericardium is peeled away from the heart. This procedure has significant risk involved, [ 14 ] with mortality rates of 6% or higher in major referral centers.
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity (the potential space) between them. [1]
The pericardium is a fibrous sac surrounding the heart composed of two layers: an inner visceral pericardium and an outer parietal pericardium. [1] The area between these two layers is known as the pericardial space and normally contains 15 to 50 mL of serous fluid. [2]
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