ConclusionÂ
Video assisted thoracoscopic surgical exploration for iatrogenic
perforations after invasive cardiac procedures is equally effective as
full sternotomy. 30-day mortality is significantly lower when compared
to standard sternotomy. Key to a good outcome is fast intervention when
hemodynamic doubt is present. The danger of underestimating the
perforation greatly outweighs the relatively minor risks of
thoracoscopic evaluation. We stress that the study population is too
small to make a solid statement. Our results are hypothesis-generating.
A larger, randomized, multicentre validation study is needed.