Author contributions:
T. Langenaeken: conceptualization, methodology, original draft
preparation
M. Van den Berg: data gathering, formal analysis, original draft
preparation
A. Kaya: review and editing
A. Yilmaz: review and editing
Abstract
Aims : Iatrogenic cardiac perforation is an uncommon but
potentially fatal complication of invasive cardiac procedures. When
non-surgical management fails, urgent cardiac surgery is required.
Standard surgical approach is usually through full sternotomy. However,
we propose a less invasive and equally effective technique with
video-assisted thoracoscopic surgery (VATS).
Methods : This single-center retrospective study in a tertiary
hospital identified all patients requiring surgical intervention due to
iatrogenic cardiac perforation over a period of 5 years. Patients were
grouped by surgical approach, being either sternotomy or VATS. Primary
endpoints were length of ICU stay, hospital stay, 30-day mortality and
all round mortality.
Results : 25 patients were identified: 11 in the
sternotomy-group and 14 in the VATS-group. Preoperative baseline
characteristics were equal. Significant difference was found for 30-day
mortality (p < 0.05). There was no difference for the other
endpoints.
Conclusions : Video-assisted thoracoscopic surgery is a
promising alternative to standard sternotomy for iatrogenic cardiac
perforations after invasive cardiac procedures.
Key words : iatrogenic cardiac perforation - complication –
invasive cardiac procedures - cardiac tamponade - pericardiocentesis