Risk factors and management strategies for periprocedural cardiac tamponade during percutaneous cardiac interventions: an 11-year single-center case-control study.

BACKGROUND: Cardiac tamponade, a life-threatening complication of cardiac intervention procedures, presents challenges in determining the optimal treatment approach. This investigation aimed to elucidate the clinical presentations of cardiac tamponade following cardiac interventions and to discern predictors favoring a non-operative management approach.

METHODS: A retrospective analysis encompassed 95,858 individuals undergoing cardiac interventions, within which 106 encountered cardiac tamponade, was conducted. The study assessed the clinical characteristics, management strategies, and outcomes of this subgroup. Logistic regression was used to identify factors that could influence therapeutic choices, and their predictive accuracy was evaluated using receiver operating characteristic curve analysis.

RESULTS: Of the 95,858 cardiac interventions conducted between 2012 and 2022 in our facility, 106 instances of cardiac tamponade fulfilled our study criteria. Among the 106 patients, 23 (21.7%) received surgical intervention, whereas 83 (78.3%) received conservative treatment. Multivariable analysis revealed that systolic blood pressure at the onset of cardiac tamponade and total drainage volume in the pericardial cavity were independently associated with the management strategies. The logistic regression model incorporating these factors yielded an area under the curve of 0.954.

CONCLUSIONS: Our findings illuminate the management landscape of cardiac tamponade subsequent to cardiac interventions, highlighting pericardial effusion volume and systolic blood pressure as pivotal factors in guiding the choice of treatment. These insights are instrumental in enhancing care for individuals afflicted with cardiac tamponade.