Delayed sequelae of penetrating cardiac injury.

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.