Aims: Iatrogenic cardiac perforation is an uncommon but
potentially fatal complication of invasive cardiac procedures. When
non-surgical management fails, urgent cardiac surgery is required.
Standard surgical approach is usually through full sternotomy. However,
we propose a less invasive and equally effective technique with
video-assisted thoracoscopic surgery (VATS). Methods: This
single-center retrospective study in a tertiary hospital identified all
patients requiring surgical intervention due to iatrogenic cardiac
perforation over a period of 5 years. Patients were grouped by surgical
approach, being either sternotomy or VATS. Primary endpoints were length
of ICU stay, hospital stay, 30-day mortality and all round mortality.
Results: 25 patients were identified: 11 in the
sternotomy-group and 14 in the VATS-group. Preoperative baseline
characteristics were equal. Significant difference was found for 30-day
mortality (p < 0.05). There was no difference for the other
endpoints. Conclusions: Video-assisted thoracoscopic surgery is
a promising alternative to standard sternotomy for iatrogenic cardiac
perforations after invasive cardiac procedures.