With a needle. A needle is introduced into the chest and through the pericardium ( the sac around the heart) into the pericardial space (between the pericardium and the heart) where excess fluid has accumulated. A flexible wire is advanced through the needle into the pericardial space and the needle is withdrawn. A flexible drain tube is advanced over the wire and the wire removed. The fluid is then drained.
By needle. The surgeon or cardiologist may do this with local or additional anesthesia depending on the issue. Fluoroscopy, ultrasound, or ct can be used to help guide the needle and / or/ catheter introduction through the skin, soft tissue, pericardium to get to the fluid or blood identified on the original test-echo.