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Han S, Hwang C. Pericardial approach for cardiac therapies: old practice with new ideas. Korean Circ J. 2010;40(10):479-88doi: 10.4070/kcj.2010.40.10.479.
Han, S., & Hwang, C. (2010). Pericardial approach for cardiac therapies: old practice with new ideas. Korean circulation journal, 40(10), 479-88. https://doi.org/10.4070/kcj.2010.40.10.479
Han, Seongwook, and Hwang, Chun. "Pericardial approach for cardiac therapies: old practice with new ideas." Korean circulation journal vol. 40,10 (2010): 479-88. doi: https://doi.org/10.4070/kcj.2010.40.10.479
Han S, Hwang C. Pericardial approach for cardiac therapies: old practice with new ideas. Korean Circ J. 2010 Oct;40(10):479-88. doi: 10.4070/kcj.2010.40.10.479. Epub 2010 Oct 31. PMID: 21088750; PMCID: PMC2978289.
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Korean Circ J. 2010 Oct;40(10):479-88. doi: 10.4070/kcj.2010.40.10.479. Epub 2010 Oct 31.

Pericardial approach for cardiac therapies: old practice with new ideas.

Korean circulation journal

Seongwook Han, Chun Hwang

Affiliations

  1. Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA.

PMID: 21088750 PMCID: PMC2978289 DOI: 10.4070/kcj.2010.40.10.479

Abstract

Treatment of cardiac disease via the epicardium fell under the domain of cardiac surgery due to the need for an open thoracotomy. Since an open thoracotomy is invasive in nature and has the potential for complications, a minimally invasive and percutaneous approach would be more attractive for suitable patients. The recent success of epicardial ablation of refractory arrhythmia via the percutaneous pericardial approach has increased the potential for delivery of epicardial therapies. Epicardial ablation has increased the success and safety since anti-coagulation and transseptal catheterization for left atrial arrhythmias is not required. The pericardial space has also been used to deliver therapy for several cardiac diseases. There are reports on successful delivery of drugs and their efficacy. Even though there was a wide range of efficacies reported in those studies, the reported complication rates are strikingly low, which suggests that direct delivery of drugs to the epicardium via the pericardial space is safe. Furthermore, recent animal studies have supported the feasibility of epicardial delivery of biological agents, including genes, cells, and even genetically engineered tissue for therapeutic purposes. In conclusion, percutaneous pericardial cannulation of closed pericardial space can play a significant role in providing non-surgical therapy for cardiovascular diseases. However, it requires skills and operator experiences. Therefore, there is need to further develop new tools, safer techniques, and effective procedure environment before generalizing this procedure.

Keywords: Administration routes, drug; Cannulation; Pericardium

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