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Cardiac and great vessel injuries after chest trauma: our 10-year experience

Burak Onan1, Recep Demirhan, Kürşad Öz

  • 1Department of Thoracic Surgery, Dr. Lütfi Kırdar Kartal Training And Research Hospital, İstanbul, Turkey. burakonan@hotmail.com

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|November 18, 2011
PubMed

Insights

Chest trauma can cause deadly cardiac and great vessel injuries. Early surgical intervention and a team approach are crucial for improving survival rates in these critical cases.

Area of Science:

  • Trauma Surgery
  • Cardiovascular Surgery
  • Emergency Medicine

Background:

  • Cardiovascular injuries following trauma are associated with high mortality rates.
  • Chest trauma represents a significant cause of potentially fatal cardiac and great vessel damage.

Purpose of the Study:

  • To present clinical experience and outcomes of managing cardiac and great vessel injuries resulting from chest trauma.
  • To analyze demographic data, injury mechanisms, and treatment strategies for patients with these severe injuries.

Main Methods:

  • A retrospective review of 104 patients with cardiac (n=94) and great vessel (n=10) injuries over a 10-year period.
  • Data collected included demographics, injury mechanism, injury location, associated injuries, surgical timing and approach, and clinical outcomes.
  • Diagnostic imaging included computed tomography (CT) and echocardiography.

Main Results:

  • The majority of patients were male (84.6%) with a mean age of 32.5 years.
  • Penetrating injuries (62.5%) were the predominant cause of trauma.
  • Right ventricle injuries were most common (58.5%); great vessel injuries involved subclavian vein, innominate vein, vena cava, and descending aorta.
  • Early surgical intervention (75.9%) via thoracotomy (89.5%) was common, with significantly high operative mortality in penetrating injuries (p=0.01).

Conclusions:

  • High index of suspicion for cardiac and great vessel trauma is essential in emergency settings.
  • CT and echocardiography are valuable diagnostic tools in managing chest trauma.
  • Optimal operative timing based on hemodynamic status and a multidisciplinary team approach are key to improving patient prognosis.
Abstract

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