Tenecteplase-Assisted Transapical Drainage of Tuberculous Pyopericardium
Video 1. Two-dimensional transthoracic echocardiography, apical 4-chamber view, and parasternal long-axis views, respectively. The large loculated pericardial effusion with increased echogenicity is clearly seen. Also visible is the decreased diastolic excursion of the lateral wall suggesting tamponade physiology that was later confirmed on detailed interrogation (not shown).
Video 2. Cineangiographic runs demonstrating contrast injection into a loculated effusion around the left ventricle accessed by transapical pericardial sheath placement. The contrast is visible, localized to a large pocket adjacent to the left ventricle alone.
Video 3. A follow-up contrast injection is shown after adhesiolysis with tenecteplase injection, revealing more diffuse pericardial filling and, thus, facilitating good pericardial catheter coverage and enabling complete drainage of the fluid.
Video 4. Post-procedure 2-dimensional transthoracic echocardiography and apical 4-chamber and parasternal long-axis views, respectively, at discharge. Both views clearly demonstrate no residual pyopericardium with significantly improved filling dynamics around the left ventricle, confirming successful pericardiocentesis.
Video Supplement to "Tenecteplase-Assisted Transapical Drainage of Tuberculous Pyopericardium" (Clinical Image).
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