Management of massive hemopericardium in the electrophysiology laboratory: The double long sheath technique

Abstract

Aim: To describe a simple and useful technique for acute management of massive hemopericardium inside the Electrophysiology (EP) laboratory. Methods and results: Five patients from a single center experience were identified, all with blood loss above 1000 ml after initial pericardiocenthesis. Using two long 8.5 F transseptal sheaths inside the pericardium space, with continuous negative pressure, allowed the complete cessation of bleeding or hemodynamic maintenance until definitive surgical repair in all patients. Conclusion: The use of two long sheaths for blood drainage, instead of conventional pericardiocenthesis, might be helpful to manage massive hemopericardium inside EP lab, avoiding urgent cardiac surgery or maintaining clinical stability until surgical staff is available.