ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Mehmet KAPLAN, Murat DEMİRTAŞ, Cem ALHAN, Serap Aykut AKA, Sabri DAĞSALI, Engin EREN, Azmi ÖZLER
Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Merkezi, İSTANBUL
Cardiac injury is one of the most important aspects of emergency cardiac surgery. The majority of these patients die because of the delay in the transportation and emergency surgical treatment. Sixty three cases with cardiac injury were operated in our clinic between January 1979 and May 1999.

Fiftyseven patients were men, and 6 women. The mean age was 27 ± 4 (min 4, max 58). There were penetrating injuries in 59 cases (knife in 48, gunshod wounds in 11), blunt traumas in 3 cases. One case having aortacoronary bypass grafting surgery had cardiac injury because of the postoperative cardiopulmonary resuscitation. The clinical status was preshock in 45, and stable in 18 cases. We performed emergency operation in 45 cases, and emergency room thoracotomy in 9 patients.

Besides the clinical findings; telegraphy, electrocardiography, central venous pressure monitoring and echocardiography were valuable for the diagnosis. We detected the increase of central venous pressure in 29, widening of heart shadow in 24, electrocardiographic changes in 10 cases. There were tamponade in 33, left haemothrorax in 17, right haemothorax in 6 and foreign bodies in 7 cases. We carried out left thoracotomy in 35, right thoracotomy in 18, median sternotomy in 10 cases. Cardiopulmonary bypass was used in only 5 cases. In all other cases, the conventional repair methods were performed. Left internal thoracic artery to left anterior descending coronary artery bypass grafting was performed in 3 cases and closure of ventricular septal defect with Dacron patch in 2 patients. In the postoperative period, 7 cases died and 4 patients were reexplored because of bleeding. The other 56 cases were discharged on the average 5th postoperative day without any complication. We think that fast transportation, urgent diagnostic workup (telegraphy, echocardiography) and immediate surgical intervention, especially ‘emergency room thoracotomy’ are very important parameters which effect the therapeutic results in cardiac injuries.

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