Emergency open-heart surgery. Experience with 100 consecutive cases

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Surgery

Background:

• Open-heart surgery is a complex procedure with associated risks.
• Emergency open-heart surgery presents unique challenges and higher mortality rates.
• Understanding risk factors is crucial for improving outcomes in urgent cardiac procedures.

Purpose of the Study:

• To analyze the outcomes of emergency open-heart surgery.
• To identify the primary clinical conditions leading to emergency cardiac operations.
• To determine the factors contributing to the increased mortality in emergency cardiac surgery.

Main Methods:

• Retrospective analysis of 1,203 open-heart operations performed between January 1973 and December 1978.
• Categorization of patients into elective and emergency surgical groups.
• Detailed examination of clinical conditions, interventions, and early (30-day) mortality rates.

Main Results:

• Overall early operative mortality was 5.3% for all open-heart surgeries.
• Emergency open-heart surgery had a significantly higher early mortality of 24%.
• Leading causes for emergency surgery included ischemic heart disease, critical valve disease, bacterial endocarditis, acute aortic dissection, and valve substitute complications.

Conclusions:

• Emergency open-heart surgery is associated with a substantially elevated risk of early death.
• Low cardiac output and left ventricular dysfunction are key factors in emergency surgery mortality.
• Earlier referral for critical valve disease could potentially decrease emergency surgery mortality rates.