Browsing by Author "Koen, Johan Gerhard"

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    Penetrating traumatic cardiac injury : experience in the current era from a high-volume tertiary hospital.
    (Stellenbosch : Stellenbosch University, 2024-03) Koen, Johan Gerhard; Janson, Jacques Teran; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Cardiothoracic Surgery.
    ENGLISH ABSTRACT: Objectives Penetrating Cardiac Injury is encountered by most surgeons at some point in their career. Prehospital and emergency department risk factors for mortality have been well established. Perioperative predictive risk factors for mortality in patients undergoing operative room surgery has not been well established. The incidence of post-operative intra-cardiac defects is not known. Early and late mortality outcomes in this patient population in the recent era is not known. Methods All suspected penetrating cardiac injuries patients who were admitted to our Trauma Unit and underwent median sternotomy between January 2014 and December 2019 were reviewed. Demographics, mechanism, and mortality, presence of intra-cardiac injuries and surgical management were assessed. Stratification and inter-variable comparison were performed. Results A total of 233 patients were identified. Mean age was 30 years with a male predominance (95%). Most were acute injuries (1 injury in 18% of cases. The presence of cardiac tamponade is highly sensitive for underlying cardiac injuries. Penetrating Zone 1 neck injuries with tamponade may avoid missing potential underlying aortic injuries. Post-operative echocardiography is advised as 23% of Ventricular Septal Defects are clinically missed on admission. We provide our algorithmic approach and surgical management of penetrating cardiac trauma.