[Re-operations in patients with heart wounds]

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Surgical Complications

Background:

• Cardiac and pericardial wounds present significant management challenges.
• Re-operations are often necessitated by postoperative complications.

Purpose of the Study:

• To identify risk factors for complications requiring re-operation in patients with cardiac and pericardial wounds.
• To develop strategies for preventing these complications.

Main Methods:

• Retrospective and prospective analysis of 1072 patients with cardiac and pericardial injuries over 35 years.
• Analysis of 28 cases requiring re-thoracotomy for bleeding-related complications.

Main Results:

• Postoperative bleeding occurred in 3.9% of cases (38 patients).
• Re-operations were performed for significant pleural drainage or persistent bleeding.
• Identified risk factors include cardiomyopathy, surgical errors, and hypocoagulation with blood loss.

Conclusions:

• Cardiomyopathy, technical/tactical errors, and hypocoagulation are key risk factors for re-operation.
• Prevention strategies involve meticulous heart wound closure, thorough intraoperative assessment, and hemostatic system correction.