A New Approach for Pericardiocentesis-Right Parasternal

Pericardiocentesis is the most useful therapeutic procedure for the early management or diagnosis of large, symptomatic pericardial effusion and cardiac tamponade. The first description of cardiac decompression was in 1653, when Riolanus suggested sternal trephination to relieve pericardial pressure. In 1911, Marfan first described the subxiphoid approach, which had been used for the blind pericardiocentesis procedure for decades, despite the significant morbidity and mortality rates (50% and 6%, respectively). In subsequent years, the techniques recommended for safe and successful pericardiocentesis have changed considerably, particularly with the introduction of fluoroscopic, electrocardiographic and, finally, echocardiographic guidance, and with the description of approaches other than the substernal one (apical and parasternal). Here, we introduce a new puncture site: right parasternal in cardiac tamponade.