Why the study?
What is the mortality rate associated with thoracotomy for penetrating cardiac injuries?
What is the mortality rate associated with thoracotomy for penetrating cardiac injuries?
Thoracotomy for penetrating cardiac injuries has a high mortality when performed on the stretcher for patients with no signs of life, but a much lower mortality when performed in the operating theater.
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Stretcher thoracotomy in agonal patients warrants extreme caution; Level 5 data leave open whether operating room transfer improves survival.
This study represents the personal experience of a general surgeon in 70 cases of penetrating injuries of the heart. Eighteen patients with no signs of life on admission were subjected to a thoracotomy on the stretcher with a mortality of 94%. Fifty-two patients were operated on in the operating theater with a mortality of 13.5%. Beck's triad (low blood pressure, raised central venous pressure, and distant cardiac sounds) was recorded in 77% of the cases with proven tamponade, but pulsus paradoxus in only 11%. In the author's opinion, percardiocentesis has no place in the diagnosis or treatment of cardiac injuries. Particular attention has been paid to the management of coronary artery injuries and the high incidence of air embolism in certain patients.
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Δημήτριος Δημητριάδης (1986) studied this question.
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