DELAYED SEQUELAE OF PENETRATING CARDIAC INJURY

Objective: We studied delayed or residual manifestations of penetratin g cardiac injury in patients to determine the incidence, type, managem ent, and outcome. Background: Penetrating cardiac injury is associated with a high mortality despite improvement in management in recent yea rs. Secondary lesions that are usually not looked for at the time of i nitial surgery are diagnosed and repaired postoperatively. Design: Ret rospective study. Setting: The study was conducted at a major urban tr auma center. Patients: Forty-eight survivors of 71 penetrating cardiac injures were treated during a 10-year period from 1980 to 1990. Resul ts: Delayed sequelae were diagnosed in 11 patients (23%) during the po stoperative period. There were five ventricular septal defects, two ao rtic valvular injuries, one atrial septal defect, two conduction defec ts, and one tricuspid valvular lesion. All lesions were repaired elect ively with 100% survival. Conclusion: We found residual or delayed seq uelae in 23% of our patients. Close follow-up and utilization of diagn ostic studies, including two-dimensional echocardiography during the e arly postoperative period, can identify late sequelae and allow electi ve repair.