Choice of incision in penetrating cardiac injuries: Which one must we prefer: Thoracotomy or sternotomy?

Ulus Travma Acil Cerrahi Derg. 2015 Jul;21(4):266-70. doi: 10.5505/tjtes.2015.52882.

Abstract

Background: Penetrating cardiac injuries are high-risk, high-mortality injuries considering the outcomes. Therefore, it is important to choose the appropriate incision. In general clinical settings, thoracotomy and median sternotomy are choices of incisions to explore the injury. In this study, the results of median sternotomy and thoracotomy in penetrating cardiac injuries were compared.

Methods: Between January 2003 and December 2013, forty patients, who underwent either thoracotomy or median sternotomy for penetrating cardiac injury, were retrospectively analyzed, and the collected data were compared. Twenty-six patients underwent thoracotomy (Group 1), and fourteen patients underwent median sternotomy (Group 2).

Results: There was no statistically significant gender difference between the groups. However, the mean age in Group 2 was found to be significantly higher than the one in Group 1 (p<0.05).

Conclusion: There were no significant survival differences between the groups in the long term. Incision choice should be determined considering the site of injury and whether there is an accompanying pulmonary injury or not. On the other hand, thoracotomy has some draw backs compared to median sternotomy.

MeSH terms

  • Adult
  • Aged
  • Decision Making*
  • Emergencies
  • Female
  • Heart Injuries / diagnostic imaging
  • Heart Injuries / mortality
  • Heart Injuries / pathology
  • Heart Injuries / surgery*
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Sternotomy*
  • Survival Analysis
  • Thoracotomy*
  • Turkey / epidemiology
  • Wounds, Penetrating / diagnostic imaging
  • Wounds, Penetrating / mortality
  • Wounds, Penetrating / pathology
  • Wounds, Penetrating / surgery*
  • Young Adult