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Risk factors and management strategies for periprocedural cardiac tamponade during percutaneous cardiac
Lihua Zhou1, Fuzhong Chen2, Muhammad Khalid1
1Department of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Insights
Cardiac tamponade after cardiac procedures can be managed non-operatively. Key predictors for non-operative management include systolic blood pressure and pericardial effusion volume, aiding treatment decisions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Cardiac tamponade is a critical complication following cardiac interventions.
- Optimal treatment strategies for post-procedural cardiac tamponade remain challenging.
- Identifying predictors for non-operative management is crucial for patient care.
Purpose of the Study:
- To describe clinical presentations of cardiac tamponade post-cardiac intervention.
- To identify predictors favoring non-operative management of cardiac tamponade.
- To inform treatment decisions for cardiac tamponade following interventions.
Main Methods:
- Retrospective analysis of 95,858 patients undergoing cardiac interventions.
- Focused on a subgroup of 106 patients who developed cardiac tamponade.
- Logistic regression and ROC curve analysis identified management predictors.
Main Results:
- 106 cases of cardiac tamponade identified from 95,858 interventions (2012-2022).
- Non-operative management was used in 78.3% of cases (83 patients).
- Systolic blood pressure and pericardial drainage volume predicted management strategy (AUC=0.954).
Conclusions:
- Pericardial effusion volume and systolic blood pressure are key factors in managing cardiac tamponade post-intervention.
- These findings can guide clinical decision-making for improved patient outcomes.
- Highlights the importance of specific clinical parameters in treatment selection.
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.
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