Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study

Abstract

Aim: Penetrating cardiac injuries (PCI) are mostly caused by sharp objects and comprise pericardial and myocardial deformation, which lead to myocardial dysfunction. Fifty percent of overall mortality in penetrating chest injuries are caused by PCIs. The aim of this study is to evaluate the results of patients who underwent cardiac surgery due to PCIs. Methods: In this retrospective cohort study, twenty-seven cases undergoing cardiac surgery due to PCI in Van Yuzuncu Yil University Hospital, Yozgat City Hospital and Bozok University Hospital between 2012 and 2019 were evaluated in terms of clinical findings, treatment methods and surgical techniques. Results: There were 3 females and 24 males. The mean age was 34.2 (13.2) years (range: 14-65 years) years. Firearms caused two and penetrating stab wounds caused twenty-five injuries, respectively. The patients were transported to the hospital within a mean time of 29.7 (14.6) minutes (range: 15-98 minutes). 29 injuries were observed in 27 patients, 18 (62.06%) of which were isolated cardiac injuries, and 11 (37.94%) were mixed type. Fourteen patients (51.8%) were operated following a transthoracic echocardiography, 12 patients (44.5%) due to clinical findings and one patient (3.7%) due to the contrast-enhanced thoracic computed tomography (TCT) result. The mean pericardial blood volume was 290 mL (range 140-460 mL) in patients with a cardiac tamponade. The most frequently injured cardiac section was the right ventricle, followed by the left ventricle. Coronary artery injuries were observed in two patients. Overall mortality rate was 44%. Conclusion: Early diagnosis, fast and safe transport, providing qualified surgical equipment, and a multidisciplinary approach are mandatory to decrease mortality and morbidity rates. It is also crucially important to prevent individual armament in preventing penetrating cardiac surgery cases.