Increasing numbers of penetrating cardiac trauma in a new center

Our aim was to express the importance of emergency diagnosis and surgical approach in penetrating cardiac trauma patients.

Koşuyolu Heart and Research Hospital moved to its new location in Cevizli Kartal in June 2005. Due to its close proximity to the main roads of the city, the number of trauma cases has increased tremendously. We have retrospectively examined our penetrating cardiac trauma cases treated between June 2005 and September 2008.

Twenty-six trauma cases were admitted to our clinic with penetrating cardiac trauma. Twenty of them were operated on an emergency basis. One (5%) had a gunshot wound while the other 19 (95%) had stab wounds. Four were female (20%) and 16 were male (80%). Average age of the patients was 24.9+/-10.1 (12-49) years. Telecardiography and transthoracic echocardiography were used for diagnosis. Surgical approaches were median sternotomy in 14 and left anterolateral thoracotomy in 6 cases. The right ventricle was damaged in 12, left ventricle in 7 and pulmonary artery in 1. Additionally, 5 patients had lung injury, 1 had brachiocephalic vein injury and 1 had coronary artery injury. One patient was re-explored for bleeding. There were two mortalities (10%) postoperatively.

Rapid transfer to the emergency department, accurate and quick diagnosis and aggressive surgical approach will increase survival in penetrating cardiac trauma.