Delayed sequelae of penetrating cardiac injury
E. K. Cha, V. Mittal and R. D. Allaben
Department of Surgery, Wayne State University, Grace Hospital, Detroit, Mich.
OBJECTIVE: We studied delayed or residual manifestations of penetrating
cardiac injury in patients to determine the incidence, type, management,
and outcome. BACKGROUND: Penetrating cardiac injury is associated with a
high mortality despite improvement in management in recent years. Secondary
lesions that are usually not looked for at the time of initial surgery are
diagnosed and repaired postoperatively. DESIGN: Retrospective study.
SETTING: The study was conducted at a major urban trauma center. PATIENTS:
Forty-eight survivors of 71 penetrating cardiac injuries were treated
during a 10-year period from 1980 to 1990. RESULTS: Delayed sequelae were
diagnosed in 11 patients (23%) during the postoperative period. There were
five ventricular septal defects, two aortic valvular injuries, one atrial
septal defect, two conduction defects, and one tricuspid valvular lesion.
All lesions were repaired electively with 100% survival. CONCLUSION: We
found residual or delayed sequelae in 23% of our patients. Close follow-up
and utilization of diagnostic studies, including two-dimensional
echocardiography during the early postoperative period, can identify late
sequelae and allow elective repair.
