title: Profile of missile-induced cardiovascular injuries in Kashmir, India.
abstract: BACKGROUND
  Missile cardiovascular injuries have taken an epidemic proportion in Kashmir valley since the eruption of militancy in 1990. Present study was undertaken to analyse the pattern, presentation and management of missile cardiovascular injuries.
  
  
  METHODS
  Three hundred and eighty-six patients with missile cardiovascular injuries since Jan 1996 to Oct 2008 were studied retrospectively. All patients of cardiovascular injuries due to causes other than missiles were excluded from the study.
  
  
  RESULTS
  All patients of missile cardiac injuries were treated by primary cardiorrhaphy. Right ventricle was the most commonly affected chamber. Left anterior thoracotomy was most common approach used. Most of the patients of missile vascular group were treated by reverse saphenous vein graft or end-to-end anastomosis. Most common complication was wound infection (20.83%) followed by graft occlusion (1.94%) in missile vascular group. Amputation rate was 4.66%. Amputation rate was higher in patients with delay of >6 hours and associated fractures.
  
  
  CONCLUSIONS
  Missile cardiac injuries should be operated early without wasting time for investigations. Clinical status at arrival, time interval till management, nature of injury and associated injuries, tell upon the mortality. Missile vascular injury needs prompt resuscitation and revascularization at the earliest. Time interval till revascularization and associated fractures has a bearing on mortality and morbidity.
authors.affiliation: Department of Thoracic Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.
authors.forename: Mohd Lateef
authors.initials: ML
authors.lastname: Wani
authors.forename: Abdul Gani
authors.initials: AG
authors.lastname: Ahangar
authors.forename: Gh Nabi
authors.initials: GN
authors.lastname: Lone
authors.forename: Zubair Ashraf
authors.initials: ZA
authors.lastname: Hakeem
authors.forename: Abdul Majeed
authors.initials: AM
authors.lastname: Dar
authors.forename: Reyaz Ahmad
authors.initials: RA
authors.lastname: Lone
authors.forename: Mohd Akbar
authors.initials: MA
authors.lastname: Bhat
authors.forename: Shyam
authors.initials: S
authors.lastname: Singh
authors.forename: Ifat
authors.initials: I
authors.lastname: Irshad