Provaznik, Zdenek and Holzamer, Andreas and Camboni, Daniele and Rupprecht, Leopold and Resch, Markus and Wittmann, Sigrid and Schmid, Christof and Floerchinger, Bernhard (2017) Perforation of myocardial wall and great vessels after cardiovascular interventions-a 5-year analysis. JOURNAL OF THORACIC DISEASE, 9 (12). pp. 5288-5294. ISSN 2072-1439, 2077-6624
Full text not available from this repository. (Request a copy)Abstract
Background: Less invasive procedures have replaced open surgical treatment in many cardiovascular disorders. During these interventions, iatrogenic cardiac perforation may ensue, which is a severe complication and requires immediate diagnostic assessment and treatment. Methods: From March 2011 to April 2016, all patients referred to the Dept. of Cardio-thoracic Surgery with the diagnosis of iatrogenic perforation of myocardial wall or great vessels were included into the retrospective study. Complications during transapical transcutaneous aortic valve replacements (TAVR) procedures and percutaneous coronary intervention (PCI) were excluded from analysis. Symptoms, therapeutic strategy, intraoperative findings, and outcome were evaluated. Results: Forty-four patients suffered from myocardial wall or vessel perforation. Most common site of perforation were right (n=26; 59.1%) and left (n=8; 18.2%) ventricle. Other structures were involved in ten cases (22.7%). Open surgical treatment was required in 27 cases (61.4%). Mortality after left and right ventricular laceration was 75.0% and 11.5%, respectively. Most common cause of death was cardiocirculatory failure (n=5). Conclusions: Iatrogenic perforation of myocardial wall or central vessels during percutaneous interventional procedures is a rare but life-threatening complication. Despite immediate treatment efforts, mortality is high, particularly after left ventricular laceration.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RIGHT VENTRICLE; MANAGEMENT; ACCIDENT; Iatrogenic cardiac perforation; cardiovascular intervention; pericardial tamponade; resuscitation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:18 |
| Last Modified: | 26 Feb 2019 11:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1722 |
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