Year 2020, Volume 4 , Issue 5, Pages 387 - 389 2020-05-01

Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study
Penetran kalp yaralanmalarında sekiz yıllık tecrübelerimiz: Çok merkezli retrospektif kohort çalışma

Zafer Cengiz ER [1] , Kıvanç ATILGAN [2]


Aim: Penetrating cardiac injuries (PCI) are mostly caused by sharp objects and comprise pericardial and myocardial deformation, which lead to myocardial dysfunction. Fifty percent of overall mortality in penetrating chest injuries are caused by PCIs. The aim of this study is to evaluate the results of patients who underwent cardiac surgery due to PCIs.
Methods: In this retrospective cohort study, twenty-seven cases undergoing cardiac surgery due to PCI in Van Yuzuncu Yil University Hospital, Yozgat City Hospital and Bozok University Hospital between 2012 and 2019 were evaluated in terms of clinical findings, treatment methods and surgical techniques.
Results: There were 3 females and 24 males. The mean age was 34.2 (13.2) years (range: 14-65 years) years. Firearms caused two and penetrating stab wounds caused twenty-five injuries, respectively. The patients were transported to the hospital within a mean time of 29.7 (14.6) minutes (range: 15-98 minutes). 29 injuries were observed in 27 patients, 18 (62.06%) of which were isolated cardiac injuries, and 11 (37.94%) were mixed type. Fourteen patients (51.8%) were operated following a transthoracic echocardiography, 12 patients (44.5%) due to clinical findings and one patient (3.7%) due to the contrast-enhanced thoracic computed tomography (TCT) result. The mean pericardial blood volume was 290 mL (range 140-460 mL) in patients with a cardiac tamponade. The most frequently injured cardiac section was the right ventricle, followed by the left ventricle. Coronary artery injuries were observed in two patients. Overall mortality rate was 44%.
Conclusion: Early diagnosis, fast and safe transport, providing qualified surgical equipment, and a multidisciplinary approach are mandatory to decrease mortality and morbidity rates. It is also crucially important to prevent individual armament in preventing penetrating cardiac surgery cases.

Amaç: Penetran kalp yaralanmaları (PKY) sıklıkla kesici-delici alet yaralanmaları sonucu gelişir ve perikard ile miyokard hasarına sebep olarak miyokardial disfonksiyona yol açar. Penetran göğüs yaralanmalarında görülen mortalite oranının %50’den fazlasından PKY sorumludur. Bu çalışmanın amacı PKY sebebiyle kalp cerrahisi uygulanan hastaların sonuçlarını değerlendirmektir.
Yöntemler: Bu çalışma retrospektif kohort çalışması olarak tasarlanmıştır. Van Yüzüncü Yıl Üniversitesi Hastanesi, Yozgat Şehir Hastanesi ve Bozok Üniversitesi Hastanesinde 2012 ve 2019 yılları arasında PKY sebebiyle kalp cerrahisi uygulanan 27 hasta klinik bulguları, tedavi ve cerrahi teknikleri açısından retrospektif olarak değerlendirilmiştir.
Bulgular: Hastaların 24’ü erkek 3’ü kadın, 24’ü erkek idi. Yaş ortalaması 34,2 (13,2) (14 ila 65 yaş aralığında) idi. İki vakada ateşli silah yaralanması, 25 vakada kesici delici alet yaralanması mevcuttu. Hastaneye olay yerinden intikal süresi 29,7 (14,6) (15 ila 98 dakika aralığında) dakikaydı. 27 hastada 29 kardiyak yaralanma mevcuttu. Bu vakaların 18’inde (%62,06) izole kalp yaralanması, ve 11’inde (%37,94) birden fazla yaralanma mevcuttu. İki hastada koroner arter yaralanması vardı. On dört hasta (%51,8) transtorasik ekokardiyografi, 12’si (%44,5) klinik bulgular ve bir hasta (%3,7) kontrastlı toraks tomografisi sonrası operasyona alındı. Tamponat kliniği veren vakalarda perikardiyal kan hacmi ortalama 290 ml (140-460 ml aralığında) idi. En sık yaralanan kalp bölgesi sağ ventrikül idi ve ikinci sırada sol ventrikül gelmekteydi. İki hastada koroner arter yaralanması tespit edildi. Genel mortalite oranı %44 olarak tespit edildi.
Sonuç: Mortalite ve morbiditenin azaltılmasında olay yerinden başlayarak erken tanı, doğru ve hızlı transport, deneyimli cerrahi travma ekipleri ile multidisipliner yaklaşım faydalı olacaktır. PKY’de hayatta kalmayı artırmamız için sağlık hizmetlerinin geliştirilmesinin yanı sıra bireysel silahlanmanın önlenmesine özellikle dikkat çekmek isteriz.

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Primary Language en
Subjects Cardiac and Cardiovascular Systems
Journal Section Research article
Authors

Orcid: 0000-0001-7129-1157
Author: Zafer Cengiz ER
Institution: YOZGAT BOZOK ÜNİVERSİTESİ, TIP FAKÜLTESİ
Country: Turkey


Orcid: 0000-0001-9907-9879
Author: Kıvanç ATILGAN (Primary Author)
Institution: TOBB ETÜ Hastanesi Kalp ve Damar Cerrahisi AD
Country: Turkey


Dates

Publication Date : May 1, 2020

Bibtex @research article { josam729522, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2020}, volume = {4}, pages = {387 - 389}, doi = {10.28982/josam.729522}, title = {Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study}, key = {cite}, author = {Er, Zafer Cengiz and Atılgan, Kıvanç} }
APA Er, Z , Atılgan, K . (2020). Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study. Journal of Surgery and Medicine , 4 (5) , 387-389 . DOI: 10.28982/josam.729522
MLA Er, Z , Atılgan, K . "Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study". Journal of Surgery and Medicine 4 (2020 ): 387-389 <http://jsurgmed.com/en/pub/issue/54145/729522>
Chicago Er, Z , Atılgan, K . "Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study". Journal of Surgery and Medicine 4 (2020 ): 387-389
RIS TY - JOUR T1 - Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study AU - Zafer Cengiz Er , Kıvanç Atılgan Y1 - 2020 PY - 2020 N1 - doi: 10.28982/josam.729522 DO - 10.28982/josam.729522 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 387 EP - 389 VL - 4 IS - 5 SN - -2602-2079 M3 - doi: 10.28982/josam.729522 UR - https://doi.org/10.28982/josam.729522 Y2 - 2020 ER -
EndNote %0 Journal of Surgery and Medicine Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study %A Zafer Cengiz Er , Kıvanç Atılgan %T Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study %D 2020 %J Journal of Surgery and Medicine %P -2602-2079 %V 4 %N 5 %R doi: 10.28982/josam.729522 %U 10.28982/josam.729522
ISNAD Er, Zafer Cengiz , Atılgan, Kıvanç . "Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study". Journal of Surgery and Medicine 4 / 5 (May 2020): 387-389 . https://doi.org/10.28982/josam.729522
AMA Er Z , Atılgan K . Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study. J Surg Med. 2020; 4(5): 387-389.
Vancouver Er Z , Atılgan K . Eight-year experiences in penetrating cardiac injury: A multi-center retrospective cohort study. Journal of Surgery and Medicine. 2020; 4(5): 389-387.