Surgical Management of Penetrating Cardiac Trauma Patients

Abstract

Introduction: Penetrating traumas, including gunshot and stab wounds, are the major causes of cardiac trauma. The aim of this study was to evaluate the diagnosis and surgical treatment in penetrating cardiac trauma patients. Patients and Methods: Forty-eight patients who underwent surgery for penetrating cardiac trauma between February 2009 and May 2017 were reviewed retrospectively. Transthoracic echocardiography, computed tomography angiography, and laboratory studies were performed if the patient was hemodynamically stable. Results: A total of 48 patients (45 males, 3 females; mean age 29.4 ± 11.1 years, range 16-51 years) were operated. Etiology was stab wound injury in 46 (95.8%) patients. Twenty-nine (60.4%) patients were in cardiogenic shock. In 44 cases, median sternotomy was performed. The most affected cardiac chamber was the right ventricle in 28 (58.3%) patients. The most common accompanying organ injury was the lungs with 15 patients. The mortality rate was 27.1% with 13 patients. Hemodynamic status of the patient, requirement of preoperative CPR, and preoperative hematocrit levels were found to have a significant effect on mortality. Conclusion: In penetrating cardiac trauma, early diagnosis and emergency surgery will improve overall survival rates. The hemodynamic status of patients on arrival have significant effect on prognosis.