Background: Despite reported low complication rates, the high volume of cardiovascular interventional
procedures performed nowadays leads to a significant number of patients suffering
from potentially life-threatening complications. This study investigates the outcomes
of patients suffering from complications caused by cardiovascular interventional procedures,
which required cardiac surgical rescue.
Method: This single-center retrospective study analyzes the outcomes of 49 patients, who
required cardiac surgical treatment of complications caused by interventional procedures.
The following baseline procedures were included: cardiac catheterization and percutaneous
coronary intervention (PCI), electrophysiological studies, and catheter ablations
such as pulmonary vein isolation (PVI), MitraClip and LAA-occluder implantation.
Results: Between April 2017 and December 2020, a total of 51 patients were admitted to our
center due to complications of cardiovascular interventions. One patient with iatrogenic
aortic dissection died prior to surgical rescue due to severe refractory cardiogenic
shock on arrival. One patient did not require surgery after drainage of pericardial
tamponade by percutaneous pericardiocentesis. Forty-nine patients required immediate
cardiac surgical rescue procedures. The two most frequent entities, which led to complications
needing emergent surgical treatment were PCI (36.7%; 18/49) and PVI (32.7%; 16/49).
Complications resulting from PCI were mainly dissections or perforations of coronary
arteries (55.6%; 10/18) and type A aortic dissections (27.8%; 5/18). Pericardial tamponade
(87.5%; 14/16) with active bleeding from myocardial or vascular perforation in all
cases was the main reason for surgical treatment after PVI. The mean duration of ICU
stay was 6.8 ± 3.8 days and average hospital stay was 9.3 ± 4.4 days. Operative mortality
occurred in one patient (2.0%) and 30-day mortality was 14.3% (7/49).
Conclusion: Despite low operative mortality, complications occurring during interventional cardiovascular
procedures carry a high postoperative mortality caused by the consequences of preoperative
hemodynamic compromise. Therefore, immediate access to cardiac surgery appears to
be important in the management of such complications.
