Penetrating Cardiac Injuries: A Complex Challenge

Asensio, Juan A.; Soto, Salvador Navarro; Forno, Walter; Roldán, Gustavo; Petrone, Patrizio; Gambaro, Esteban; Salim, Ali; Rowe, Vincent L.; Δημητριάδης, Δημήτριος

doi:10.1007/s595-001-8055-0

Cited by 41 publications

(62 citation statements)

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“…Most patients (151/186, 81.2%) had wounds in the so-called "heart area" (precordium), which is shown in Figure 1. A similar dangerous area is shown by other authors [4,22,23].…”

Section: Cardiac Surgerysupporting

confidence: 87%

“…It was found in 82.4% of survivors and 42.9% of non-survivors, p < 0.001. Some authors also conclude that the more SOL found on admission the greater opportunity to survive [20,22,27].…”

Section: Discussionmentioning

confidence: 99%

“…For the rest the operation was delayed due to numerous reasons. In some clinics and hospitals patients with suspected heart injury were being operated on at the emergency department operating room [4,14,20,22,27]. All the patients in our series were operated on in the operating theatre of the Department of General Thoracic Surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In our opinion, there is no strong necessity to spend a huge amount of money in order to arrange an emergency department operating room, having well-equipped operating rooms nearby. According to Asensio et al, the survival rate is higher in patients operated on in a routine way in comparison with emergency department surgery [22]. This might be explained by the fact that most patients operated on at the emergency department are in a critical condition, and emergency room thoracotomy is often considered a controversial "last chance" method of resuscitation.…”

Section: Discussionmentioning

confidence: 99%

“…Heart injury severity score was evaluated according to the American Association for the Surgery of Trauma (AAST) Heart injury scale, which includes six grades [15,21,22].…”

Section: Methodsmentioning

confidence: 99%

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CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Jagelavičius¹,

Budra²,

Jovaišas³

et al. 2013

kitp

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1 StreszczenieWstęp: Rany kłute serca są dramatycznymi, prowadzącymi do zgonu urazami. Na ogół zdarzają się u ludzi młodych. Więk-szość ofiar umiera przed przyjęciem do szpitala. Cel pracy: Celem pracy było określenie czynników decydują-cych o wynikach leczenia i rokowaniu chorych z ranami kłu-tymi serca. , p = 0,031), wyższy stopień urazu (IV-VI) (90,5% vs 29,7%, p < 0,001), uraz prawego przedsionka (28,6% vs 8,5%, p = 0,014) lub lewej komory (42,9% vs 23,0%, p = 0,049) i epizody zatrzymania krążenia (85,7% vs 7,9%, p < 0,001). Niezależnym prognostycznym czynnikiem przeżycia była obecność wszystkich czynników SOL oraz młodszy wiek. Wyższy stopień urazu (IV-VI) oraz zatrzymanie krążenia w trakcie operacji były niezależnymi czynnikami zgonu. Wnioski: Prekursorami złego rokowania były niższe wartości ciśnienia tętniczego oraz brak co najmniej jednego z czynni- CARDIAC SURGERY AbstractBackground: Penetrating cardiac injuries are a dramatic and lethal form of trauma. They are usually sustained by young people. The majority of victims die before reaching the hospital. Aim of the study: The aim of the study was to establish prognostic criteria for the outcome of penetrating cardiac injury. Material and methods: We retrospectively reviewed the records of 186 patients with penetrating cardiac injuries who were operated on during the first 24 hours after admission. Results: The mean age was 33 (interquartile range (IQR): 26-44) years. 88.7% of victims were male. The mean time from the moment of trauma to arrival at the hospital in Vilnius city was 60 minutes (IQR: 50-91), whereas from the Vilnius region it was 240 (IQR: 82-390) minutes. The vast majority of patients (176/186, 94.6%) sustained stab wounds. Hemopericardium or cardiac tamponade (142/186, 76.3%) usually was found at the operation. Right ventricle was the most often injured heart chamber (75/186, 40.3%). Associated injuries were evaluated in 57.0% (106/186) of patients. The survival rate on discharge was 88.7%. Compared to non-survivors, the lucky patients had a higher systolic blood pressure on admission (94 mm Hg (IQR: 70-120) versus (vs.) 70 mm Hg (IQR: 0-80), p < 0.001). Survivors had all signs of life (SOL) more often (82.4% vs. 42.9%, p < 0.001), whereas more frequent findings in non-survivors were the following: tamponade (52.4% vs. 29.1%, p = 0.031), higher grade (IV-VI) of injury (90.5% vs. 29.7%, p < 0.001), injured right atrium (28.6% vs. 8.5% p = 0.014) or left ventricle (42.9% vs. 23.0%, p = 0.049) and an episode of heart arrest (85.7% vs. 7.9%, p < 0.001). Independent prognostic factors of survival were the presence of all SOL and younger age. Higher grade (IV-VI) of heart injury and heart arrest during surgery independently predicted mortality. Conclusions: According to our data, lower arterial blood pressure and absence of one or more SOL on admission, cardiac tamponade, higher grade injury, injured right atrium and asystole during operation are true precursors of fatal outcome.

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“…Most patients (151/186, 81.2%) had wounds in the so-called "heart area" (precordium), which is shown in Figure 1. A similar dangerous area is shown by other authors [4,22,23].…”

Section: Cardiac Surgerysupporting

confidence: 87%

“…It was found in 82.4% of survivors and 42.9% of non-survivors, p < 0.001. Some authors also conclude that the more SOL found on admission the greater opportunity to survive [20,22,27].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Heart injury severity score was evaluated according to the American Association for the Surgery of Trauma (AAST) Heart injury scale, which includes six grades [15,21,22].…”

Section: Methodsmentioning

confidence: 99%

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