Outcomes of Post-Traumatic Cardiac Injury: A 17-Year Retrospective Study at Tertiary Centers

Abstract

Objective: To evaluate demographics, injury patterns, diagnostics, surgical strategies, and outcomes in cardiac trauma managed at tertiary hospitals, and to contextualize findings against contemporary literature. Materials and Methods: This retrospective observational study included 108 patients with consecutive cardiac injury cases from January 2006 to December 2022. Inclusion required confirmed cardiac involvement by echocardiography, computed tomography, intraoperative findings, or autopsy, with complete clinical records. Data included mechanism and location of injury, diagnostics (ECG, FAST, echocardiography, CT, angiography), interventions, complications, and mortality. Results: Among 108 patients (87% male; mean age 34.8±12.6 years), penetrating injuries were most common (51%; knives 64%, firearms 29%), with all blunt injuries caused by traffic accidents. The right ventricle was the most frequently injured (32%), followed by the left ventricle (15%) and atria (12%). Coronary (4%) and great vessel (3%) injuries were less frequent. FAST was positive for tamponade/hemopericardium in 82% of cases; echocardiography detected pericardial effusion (18%) and valve lesions (7%). Sternotomy was performed in 64%, thoracotomy in 21%, and pericardial window or drainage in 10%; myocardial laceration repair was most common, with Teflon-felt support used in 12%. Complications occurred in 27% of cases, including arrhythmias (15%), effusions (8%), and infections (7%). Overall mortality was 8.3% (early 5.5%, late 2.8%), with most deaths related to great vessel or multi-organ injuries. Conclusion: Standardized, rapid diagnostic pathways (notably FAST) and hemodynamics-guided surgical strategies, including damage control principles, are associated with comparatively low mortality rates in cardiac trauma. Multidisciplinary protocols may further improve outcomes.