心导管术所致心脏压塞

目的:探讨心导管检查术及心脏介入术中发生心脏穿孔、心脏压塞的原因及紧急处理的方式和效果.方法:回顾性分析1986年1月至2009年12月在中南大学湘雅二医院心导管室接受诊断性心导管检查术或各种心脏介入术共23 319例患者的资料.结果:在23 319例各种心导管术中,共有22例(0.094%)发生急性心脏压塞.其分布情...

Cardiac perforation and tamponade in percutaneous cardiac intervention

ObjectiveTo 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. MethodsThe clinical data from 23 319 patients who received diagnostic catheterization or therapeutic procedures were analyzed retrospectively. ResultsCardiac 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. ConclusionCardiac 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.