Análise epidemiológica das pericardiotomias realizadas em um hospital universitário de Curitiba

Abstract

The pericardiostomy were performed mostly in young men with penetrating trauma caused by gunshot wounds., in its majority with injury of the right ventricle as main finding, which agreed to the reviwed literature.

O uso da tomografia computadorizada na triagem da lesão cardíaca penetrante.

“…Penetrating heart injuries represent a significant mortality cause, and can be challenging either from the therapeutic or the diagnostic point of view, since they can be asymptomatic or oligosymptomatic for a variable period after a trauma occurs 6,11,14 . Most studies show that young men are the most struck by penetrating heart injuries, which is in consonance with our outcomes 5,7,8,[14][15][16][17][18] .…”

“…The most frequent mechanism among patients operated due to penetrating heart traumatism is stab wounds, in a proportion ranging from 39% to 81.4% 3,7,8,15 . Necropsy research suggests that firearm wounds (GSW) are the most frequent 2 ones.…”

“…It is interesting to point out that among the 23 cases where operatory findings were classified as compatible with heart injury, in six patients there was hemopericadium, but no injury to any cardiac chamber or intrapericardial vessel was found (five cases went through pericardial window followed by thoracotomy, and in one case no pericardial window was performed). This finding of blood inside the pericardium, without detecting intrapericardial structure injury is described as a false positive result of the pericardial window, and this can happen in 18% to 30% of the cases 8,19 . According to the casuistry of the present study, this happened in 25% of the pericardial windows.…”

“…The right ventricle is often described as the most affected cardiac chamber in penetrating injuries, because it accounts for most of the anterior surface of the heart (sternocostal), with predominance ranging from 30% to 48% 3,8,13,[19][20][21] .…”

“…Nonetheless, it is less and less performed due to its invasive character 3,4 . In better equipped centers, the pericardial window can be substituted by less invasive methods, like FAST (Focused Assessment with Sonography for Trauma) 3,8 .…”