Introduction
Invasive cardiac procedures such as percutaneous coronary interventions
and electrophysiology procedures have been well established as an
effective treatment for coronary lesions and cardiac arrhythmias. Due to
their increasing caseload, the low frequency of procedure-related
complications can still be a substantial patient group in high-volume
centres(1), especially at times when the use of antiplatelet and
anticoagulation medication is increasing(2). Acute tamponade due to
cardiac perforation is a life-threatening complication. It has been
reported that tamponade complicates 0,09-1,42% of invasive cardiac
procedures in high-volume centres(3). In most cases, the primary
management is pericardiocentesis. However, this is insufficient in up to
50% of tamponade cases(1). When non-surgical management fails, urgent
surgical exploration is required. The standard surgical approach is
almost exclusively by median sternotomy(4). We propose a less invasive
technique by thoracoscopic exploration. The aim of this study is to
analyse the benefits of video assisted thoracoscopic surgery (VATS) in
the surgical treatment of iatrogenic cardiac perforation compared to
sternotomy.