Rodríguez-Ortega MF, Cárdenas-Martínez G, Vázquez Minero JC, Gómez GMA, Vega RF, Zepeda SJR, Gutiérrez OR, González ÁJ

Language: Spanish
References: 12
Page: 7-12
PDF size: 529.97 Kb.

ABSTRACT

Objective: To analyze our experience in the surgical treatment of heart lesions due to penetrating trauma.
Setting: Third level health care hospital.
Design: Retrospective, observational study.
Patients and methods: We reviewed the clinical records from 45 patients with thoracic penetrating trauma and heart lesion antecedents registered from March 1997 to March 2002. We analyzed the following variables: Mechanism and site of the lesion, gender, age, diagnosis, performed thoracotomy, used suture, associated lesions, morbidity and mortality. All patients were classified according to the heart lesion scale.
Results: Patients corresponded to 42 men and 3 women, average age of 26 years (range 18 to 50), The cardiac lesion was caused by stabbing in 35 patients (77%) and by fire arm in 10 (23%). The sites of the lesions corresponded to: the left ventricle in 17 patients (37%), the right in 16 (35%), and the pericardium in 7 (15%). Cardiac lesion IV degree was the most frequent in 21 patients (46%) followed by V in 17 (37%). Surgical repair consisted of: “U” sutures with pericardial patch in 23 patients. Thirty-nine thoracotomies were performed in the operating room and six in the trauma-shock room, 37 were left antero-lateral, 7 right antero-lateral, and 1 sternotomy. There were 12 associated intrathoracic lesions, most of them (10) in the lung; besides 3 liver lesions were encountered. Post-operative morbidity was of 22%. Hospital stay averaged 9 days (7 to 15), and mortality was of 48% (22 patients died).
Conclusion: Mortality due to cardiac lesions is still high. Timely diagnosis and early surgery play a key role in diminishing mortality.

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