Missile cardiac injuries: review of 16 years' experience.
BACKGROUND
Penetrating cardiac trauma represents an increasingly important form of trauma due to the frequent use of firearms and bombs in civilian violence. We report our experience over the past 16 years with missile-induced cardiac injuries.


METHODS
A retrospective study reviewing 40 cases (30 males, 10 females) of missile cardiac injuries was conducted. The nature of injuries, management and outcomes were analyzed.


RESULTS
The ages ranged from 14-68 years. The mean time in which patients reached the hospital was 4.1 hours. Forty percent of the patients had firearm injuries and the remaining 60% had pellet or splinter injuries to the heart. Survival was noted in 37.5% in the gunshot group and in 66.6% in the splinter/pellet group. The survival in patients with isolated cardiac injury was 60%, while it was only 40% in those with associated injuries. Single-chamber injury was noted in 87.5% of the patients and the survival in these was 62.8%. Fourteen complications were noted in the patients who were resuscitated. One patient was re-explored for excessive bleeding and a missed right ventricular perforation was repaired.


CONCLUSIONS
In missile cardiac injuries, results are best if operated early, and outcome depends upon multiple factors including clinical status at arrival, time interval till management, nature of injury, and associated injuries.
Lone
Reyaz Ahmed
RA
Department of Cardiovascular and Thoracic Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Jammu and Kashmir, India.
Wani
Mehmood Ahmad
MA
Hussain
Zahur
Z
Dar
Abdul Majid
AM
Sharma
Mukhand Lal
ML
Bhat
Mohd Akbar
MA
Ahangar
Abdul Gani
AG
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006335:Heart Injuries / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000401:mortality / Q000601:surgery; D014950:Wounds, Penetrating / Q000401:mortality* / Q000601:surgery; D055815:Young Adult