Kardiyak Travmada Cerrahi Tedavi Deneyimi: Tek Merkezli Çalışma

Abstract

Objective: Cardiac trauma has a high mortality rate and requires emergency diagnosis and surgical treatment. This retrospective study was planned to evaluate outcomes of patients who underwent urgent surgical treatment for cardiac trauma using valuable injury scoring systems.Material and Methods: All traumatic patients who applied to our emergency service and performed surgical operations due to cardiac trauma between January 1985 and November 2021 by cardiovascular surgeons, were analyzed retrospectively. The patients with iatrogenic cardiac trauma after the percutaneous intervention were also included in the study population. Cardiac injury scales such as physiological index (PI), penetrating cardiac trauma index (PCTI), penetrating thoracic trauma index (PTTI), and American Association for the Surgery of Trauma/Organ Injury Scale (AAST/OIS), were calculated in all patients for clinical severity.Results: In this study, 39 patients were enrolled. 24 patients (61.6%) had penetrating, 13 (33.3%) iatrogenic, 2 (5.1%) blunt cardiac injuries. 15 patients (38.5%) had penetrating stab wounds, and 9 (23.1%) had gunshot wounds. The mean age of the patients was 48.3±19.0 (min: 6-max: 87) years, and 79.6% were male. The most frequently injured cardiac chambers were right ventricle (RV) (46.2%), left ventricle (LV) (25.6%), right atrium (RA) (10.3%), and coronary arteries (10.3%), respectively. While the number of patients with cardiac tamponade was 25 (64.1%), additional abdominal injuries were detected in 6 (15.4%) patients. 80% of the patients with cardiac tamponade survived (p=0.006). The mortality rate was 35% for penetrating injuries in this study.Conclusion: This study, which included patients with cardiac trauma from a single-center, draws attention in terms of showing the negative effect of cardiac tamponade on mortality. Our study outcomes also do not support the old dictum that left ventricular injuries have higher mortality.