[Cardiac perforation and tamponade in percutaneous cardiac intervention].

OBJECTIVE

To explore the cause of cardiac perforation and tamponade during cardiac catheterization and intervention and to evaluate the effectiveness of the emergency treatment for tamponade in our hospital.

METHODS

The clinical data from 23, 319 patients who received diagnostic catheterization or therapeutic procedures were analyzed retrospectively.

RESULTS

Cardiac perforation and cardiac tamponade were observed in 22 of the 23, 319 patients during catheter procedures. It includes 1 in coronary artery angiography, 9 in percutaneous balloon mitral valvuloplasty, 3 in diagnosis, 2 in congenital heart disease intervention, 2 in pacemaker implantation, 2 in atrial fibrillation ablation and the other 3 in coronary revascularization. The occurrence of cardiac perforation in 11 patients was related to puncture of the interatrial septum and/or the procedure in the left atrial procedure and 2 were related to high pressure injection. Seventeen patients were found cardiac tamponade in the process of catheterization, and 5 were found at 2-14 h after operation. Pericardiocentesis and pericardial catheter drainage were performed in 20 patients and 11 of them succeeded. Among the other 11 patients, 7 were successfully saved by thoracotomy and 4 died.

CONCLUSION

Cardiac tamponade is a severe and fatal complication that may occur in different catheter procedures. Early prevention and diagnosis and performingperi cardiocentesis and drainage timely are critical to reduce the mortality.