PENETRAN KALP YARALANMALARINDA MORTALÝTEYÝ ETKÝLEYEN FAKTÖRLER

1988-1995 arasý 7 yýllýk dönemde 57 penetran kalp travmalý hasta Ýstanbul Týp Fakültesi Acil Cerrahi Ünitesinde tedavi edildi. 7(%18.9) hastada kompleks kalp yaralanmasý vardý; 5'inde tru and tru, 2 sinde iki ayrý giriþli. Sað ventrikülde 23, sol ventrikülde 16, atriumlarda ise toplam 11 yaralanma saptandý. 15 hasta kardivak are tablosunda geldikleri için acil torakotomi gerekti. Diðer hastalar ise daha rahat ameliyata alýnmaya müsaade edecek kadar stabil idiler. Toplam 18(%31.5) hastamýzý kaybettik. Kardiyopulmoner bypass hiç bir hastamýzda kullanýlmadý. Penetran kalp travmalý hastalarýn hastane öncesi resüsitasyon ve hýzlý transportlarý mortaliteyi önemli ölçüde etkilemektedir.

THE FACTORS EFFECTING MORTALITY IN PENETRATING HEART WOUNDS

During a 7-year period (1988-1995), 57 patients with penetrating wounds to the heart were treated at the Surgical Emergency Unit of Istanbul Medical Faculty. Seven patients (18.9%) had complex cardiac stab wounds, 5 had through and through stab wounds, 2 had two-entrance wounds. Twenty-three wounds were to the right ventricle, 16 wounds were to the left ventricle, and 11 wounds involved the atrial chambers. Fifteen patients required emergency thoracotomy, because of arriving pulseless in the emergency department. The other patients' were stable enough to allow immediate surgery. There were 18 in-hospital deaths (%31.5). Cardiopulmonary bypass was not used during primary surgical repair. The prehospital care and rapid transportation of victims of penetrating heart trauma influence patients survival markedly.