Author/Editor		Herlihy, James P.; Loyalka, Pranav; Gnananandh, Jayaraman; Gregorič, Igor; Dahlberg, Carl G. W.; Kar, Biswajit; Delgado, Reynolds M.
Title		PleurX catheter for the management of refractory pleural effusions in congestive heart failure
Type		članek
Vol. and No.		Letnik 36, št. 1
Publication year		2009
Volume		str. 38-43
ISSN		0730-2347 - Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
Language		eng
Abstract		Pleural effusions that are caused by congestive heart failure and refractory to medical management are rare, and the options for treating them are few and sometimes ineffective. We report here our experience, over a 2-year period, with a novel device, the Denver Biomedical PleurX pleural catheter, in treating a series of 5 patients who had chronic, refractory, heart-failure-associated pleural effusions. The PleurX catheter is a small-bore chest tube designed to remain in place for prolonged periods, through which drainage of pleural fluid can be performed easily on a daily or less frequent outpatient basis. Placement of the catheter, in our series, was associated with no complications. In all patients, the catheter effectively drained the pleural space initially, thereby controlling the effusions and alleviating New York Heart Association functional class IV symptoms. The catheters remained in place for a period of 1 to 15 months. In 2 of the patients, the catheter was associated with no complications during the time that it remained in place. One of these patients had the catheter removed at heart transplantation, and 1 retained the catheter until death from underlying heart disease. For 1 patient, the catheter resulted in a partially loculated pleural space, and it was removed. In 2 patients, after prolonged use, it was associated with empyema, for which it was removed. We conclude that the PleurX catheter can effectively control refractory congestive-heart-failure-associated pleural effusions temporarily, but that its prolonged use can cause significant complications, most importantly empyema.
Keywords		ambulatory care catheters heart failure ambulantna oskrba katetri srčno popuščanje