Our Surgical Management Strategy for Cardiac Injury
Mehmet Atay, Vedat Bakuy, Onur Saydam, Emrah Ereren, Ali Aycan Kavala, Emrah Si̇sli̇, Saygın Türkyılmaz
Keywords: Heart Injuries, in hospital mortality, early medical intervention
Introduction: The aim of this study was to retrospectively review patients who were diagnosed with cardiac injury and underwent an emergency surgery. Patients and Methods: Between January 2009 and December 2014, 37 patients diagnosed with cardiac injury were retrospectively evaluated. Patients were evaluated according to the demographics, mean time from admission to surgery, concurrent interventions, type and localization of cardiac injury, and preoperative mean arterial blood pressure. Results: Eight patients who suffered from cardiac arrest underwent emergency surgery by thoracotomy. On admission to emergency service (ES), 22 patients were in shock. In ES, because the hemodynamic situation of six patients worsened despite fluid therapy, they underwent surgery without performing additional tests or imaging. The localization of the injuries were the right ventricle in 19 patients, left ventricle in 15 patients, right atrium in 2 patients, and both the right and left ventricles in 1 patient. In 34 patients, the primary suturing technique was sufficient for repair but two patients were operated on using cardiopulmonary bypass. The mean time from admission to surgery was 3.16 ± 2.37 h. The mean duration of intensive care unit stay was 2.37 ± 2.1 days. On an average, 5.16 ± 4.21 units of packed erythrocyte suspension were transfused. The mortality rate was 37.83% (n= 14). Conclusion: Improvements in emergency interventions, transportation, and availability of echocardiography in the emergency departments have to be more appropriate and efficient for better outcome in the new series.