Current Treatment Approaches for Isolated Penetrating Cardiac Injuries

Year 2022, Volume: 9 Issue: 1, 49 - 52, 29.04.2022

Metin Onur Beyaz , Didem Melis Öztaş , Murat Uğurlucan

https://doi.org/10.47572/muskutd.856757

Abstract

Penetrating cardiac injuries have a high mortality rate due to serious clinical outcomes. In this study, potential postoperative complications as well as the intraoperative evaluation of penetrating cardiac injuries are reviewed. Aim of this study was to investigate the patients who underwent surgical treatment for penetrating cardiac injury in our hospital. Between April 2016 and June 2017, 8 patients who underwent surgical intervention in the Cardiovascular Surgery Clinic due to penetrating cardiac injury were evaluated retrospectively. 4 patients underwent left anterolateral thoracotomy, 3 patients underwent sternotomy and 1 patient underwent surgery with right anterolateral thoracotomy. The pericardium was opened to discharge the tamponade. After bleeding was controlled, cardiac injuries were repaired primarily by using pericardial plaget with prolene sutures. In conclusion, cardiac injuries are more common in the younger age group, but traumas can be reduced by timely and appropriate medical intervention. In order to increase survival, we believe that the intervention rooms to be formed in the emergency room are fully equipped and the in-service training programs for the auxiliary health personnel are important factors.

Keywords

Emergency Surgery, Isolated Cardiac Injury, Penetrating

İzole Penetran Kardiyak Yaralanmalarda Güncel Tedavi Yaklaşımları

Abstract

Penetran kardiyak yaralanmalar, ciddi klinik sonuçları sebebiyle yüksek mortalite oranına sahiptir. Çalışma da penetran kardiyak yaralanmaların operasyon anı değerlendirilmesinin yanın da operasyon sonrası olası komplikasyonlar gözden geçirilmiştir. Bu çalışmanın amacı, hastanemizde penetran kardiyak yaralanma nedeniyle cerrahi tedavi uygulanan hastaların araştırılmasıdır. Nisan 2016 ile Haziran 2017 tarihleri arasında penetran kalp yaralanması sebebiyle Kalp ve Damar Cerrahisi Kliniğinde cerrahi girişim uygulanan 8 olgu geriye dönük olarak incelendi. Acile başvuran 4 olguda sol anterolateral torakotomi,3 hastada sternotomi,1 hastada ise sağ anterolateral torakotomi ile cerrahi girişim uygulandı. Perikard açılarak tamponad boşaltıldı. Kanama kontrol altına alındıktan sonra kardiyak yaralanmalar prolen dikişlerle perikardiyal plaget kullanılarak primer olarak onarıldı. Sonuç olarak, kardiyak yaralanmalar genç yaş grubunda daha sık görülen, ancak zamanında ve uygun tıbbi girişimle mortalitenin düşürülebileceği travmalardır. Sağ kalımın artırılması için, acil serviste oluşturulacak girişim odalarının tam donanımlı olması ve yardımcı sağlık personeline hizmet içi eğitim programları uygulanmasının önemli faktörler olduğu kanısındayız.

Keywords

Acil Cerrahi, İzole Kardiyak Yaralanma, Penetran

References

• 1. Campbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. Review of 1198 cases of penetrating cardiac trauma. Br J Surg. 1997;84:1737-40.
• 2. Manduz Ş, Katrancıoğlu N, Bingöl H, Atlı H, Doğan K. Penetrating cardiac injuries. Turk Gogus Kalp Damar Cerr Derg. 2008;16(4):228-31.
• 3. Arıkan S, Yücel AF, Kocakuşak A, Dadük Y, Adaş G, Önal MA. Penetran kardiyak travmalı hastaların retrospektif analizi. Ulus Travma Derg. 2003;9:124-8.
• 4. Ivatury RR, Rohman M, Steichen FM, Gunduz Y, Nallathambi M, Stahl WM. Penetrating cardiac injuries: twenty-year experience. Am Surg. 1987;53:310-7.
• 5. Kaljusto ML, Skaga NO, Pillgram-Larsen J, Tønnessen T. Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center. Scand J Trauma Resusc Emerg Med. 2015;3;23:41.
• 6. Dereli Y, Özdemir R, Ağrış M, Öncel M, Hoşgör K, Özdiş A. Penetrating cardiac injuries: assessment of 21 patients. Ulus Travma Derg. 2012;18 (5):441-5.
• 7. Ülkü R, Eren Ş, Balcı A, Özçelik C, Eren MN. Penetran kalp yaralanmalı olgularımızın analizi. Ulus Travma Derg. 2001;7:172-5.
• 8. Christie-Large M, Michaelides D, James S. Focused assessment with sonography for trauma: the FAST scan. Trauma. 2008;10(2):93-101.
• 9. Davies GE, Lockey DJ. Thirteen survivors of prehospital thoracotomy for penetrating trauma: a prehospital physician-performed resuscitation procedure that can yield good results. J Trauma. 2011;70(5):75-8.
• 10. Chen CY, Hsu TY, Chen WK, Muo CH, Chen HC, Shih HM. The use of extracorporeal membrane oxygenation in trauma patients: A national case-control study. Medicine (Baltimore). 2018;97(36):e12223.
• 11. Chang CH, Chen HC, Caffrey JL, et al. Survival analysis after extracorporeal membrane oxygenation in critically ill adults: a nationwide cohort study. Circulation. 2016;133(24):2423-33.
• 12. Hsu CP, Lee WC, Wei HM, et al. Extra corporeal membrane oxygenation use, expenditure, and outcomes in taiwan from 2000 to 2010. J Epidemiol. 2015;25:321-31.
• 13. Ivatury RR, Nallathambi MN, Rohman M, Stahl WM. Penetrating cardiac trauma. Quantifying the severity of anatomic and physiologic injury. Ann Surg. 1987;205:61-6.
• 14. Çıkrıkçıoğlu M, Yağdı T, Posacıoğlu H, et al. Penetran kalp yaralanmaları. Ulus Travma Derg. 2000;6:189-92.
• 15. Rollins MD, Koehler RP, Stevens MH, et al. Traumatic ventricular septal defect: Case report and review of the English literature since 1970. J Trauma. 2005;58:175–80.
• 16. Mason DT, Roberts WC. Isolated ventricular septal defect caused by nonpenetrating trauma to the chest. Proc (Bayl Univ Med Cent). 2002;15:388–90.
• 17. Pierli C, Iadanza A, Del Pasqua A, Sinicropi G. Unusual localisation of a ventricular septal defect following blunt chest trauma. Heart. 2001;86:E6.
• 18. Pruitt CM, Titus MO. Ventricular septal defect secondary to a unique mechanism of blunt trauma: A case report. Pediatr Emerg Care. 2007;23:31–2.
• 19. Closey DN, Long G, Lin Z, Mehrota D, Havill JH. Isolated ventricular septal defect secondary to low – velocity blunt chest trauma. Crit Care Resusc. 2001;3:95–6.
• 20. Genoni M, Jenni R, Turina M. Traumatic ventricular septal defect. Heart. 1997;78:316–8.
• 21. Kulshrestha P, Das B, Iyer KS, et al. Cardiac injuries - a clinical and autopsy profile. J Trauma 1990;30:203-7.