Ulus Travma Acil Cerrahi Derg. 2007; 13(3): 199-204

Penetrating cardiac injuries

Mehmet Uludað¹, Gürkan Yetkin¹, Fevzi Celayir², Bülent Çitgez¹, Can Baþaran², Adil Baykan^2
1Department Of 2nd General Surgery, Þiþli Etfal Training And Research Hospital, Istanbul, Turkey
²Department Of 1st General Surgery, Þiþli Etfal Training And Research Hospital, Istanbul, Turkey

BACKGROUND The aim of this study was to evaluate our clinical findings and results of cardiac injuries. METHODS We reviewed the records of patients who were admitted to our clinic between 1996 and 2005 and operated due to penetrating cardiac injury. RESULTS Eighteen patients (17 male, one female; mean age 25.9; range 17-45 years) (all penetrating stab wounds) with cardiac injuries were operated. The clinical aspects were: agonal status in 5 patients (27.8%), profound shock in 7 patients (38.9%). The remaining 6 patients (33.3%) were in mild shock (hypotension 60-90 mmHg) and 3 of them (16.7%) had a diagnosis of cardiac tamponade preoperatively. Emergency room thoracotomy was made in 2 patients (11.1%). Mortality rate was %80 in agonal patients whereas overall mortality was 44.5%. CONCLUSION Cardiac injuries have high mortality. The mortality rate of the patients, who can arrive to the hospital alive, is c l o s ely related to the vital signs and general condition. The mortality can be reduced by quick evaluation and prompt surgical intervention.

Keywords: Heart injuries/ epidemiology/ mortality, penetrating injuries, stab wounds/mortality.

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Penetran kalp yaralanmalarý

Mehmet Uludað¹, Gürkan Yetkin¹, Fevzi Celayir², Bülent Çitgez¹, Can Baþaran², Adil Baykan^2
1Þiþli Etfal Eðitim Ve Araþtýrma Hastanesi 2. Genel Cerrahi Kliniði, Ýstanbul
²Þiþli Etfal Eðitim Ve Araþtýrma Hastanesi 1. Genel Cerrahi Kliniði, Ýstanbul

AMAÇ Kalp yaralanmalarýndaki klinik bulgularý ve tedavi sonuçlarýný deðerlendirmektir. GEREÇ VE YÖNTEM 1996-2005 tarihleri arasýnda kliniðimizde kalp yaralanmasý nedeniyle cerrahi giriþim uygulanan hastalarýn verileri deðerlendirildi. BULGULAR Tümü delici kesici alet ile yaralanan, 18 hasta (17 erkek, 1 kadýn; ort. yaþ 25,9; daðýlým 17-45) ameliyat edildi. Acil servise getirildiklerinde beþ hasta (%27,8) agonide, yedi hasta (%38,9) derin þokta idi. Diðer altý hastada (%33,3) hipotansiyon (60-90 mmHg) vardý; hastalarýn üçüne (%16,7) ameliyat öncesi perikard tamponadý tanýsý konuldu. Ýki hastaya (%11,1) acil servis torakotomisi yapýldý. Agonideki hastalarda mortalite %80 olup, genel mortalite %44,5 idi. SONUÇ Kalp yaralanmalarý yüksek mortaliteye sahip olup, hastaneye ulaþabilen hastalarýn vital bulgularý ve genel durumlarý prognozu belirler. Bu hastalarda hýzlý deðerlendirme ve gecikmeden yapýlacak cerrahi giriþim mortaliteyi azaltacak en önemli faktörlerdir.

Anahtar Kelimeler: Kalp yaralanmalarý/ epidemiyoloji / mortalite, penetran yaralanmalar, delici kesici alet yaralanmasý/mortalite.

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