Surgical Outcomes of Emergency Cardiac Operations

Objectives: Emergency cardiac operations have more complications and mortality than elective operations. We have evaluated the complications and mortality and the most predicted cause of them in emergency cardiac operations. Methods: In a retrospective, case series, descriptive study that was done in Rajaei Heart Center in Tehran between March 2005 to March 2007 from 6881 patients that were operated for cardiac disorders, we selected 208 of them that the operation was done before 24 hours of diagnosis and evaluated them as emergency operations. Parameters like age, sex, Kind of operation, Pump Time and Clamp Time, ICU Stay, Hospital stay, complications and early and late mortality were collected and analyzed. Results: From 208 patients who were operated as emergency setting, 51.9% were Female and 48.1% were male. Mean age was 39.14+_21.32 years, mean admit time was 14.7+_9.8 days and mean follow-up time was 8 months. Early mortality rate was 17.78% and in operation room mortality was 3.33%.There were no relationships be- tween age, sex and mortality (P-value 0.378, 0.467). Congestive heart failure in 51.8%, respiratory failure in 24.3 % and multiple organ failure in 24.3% were the conductive causes of mortality. Other complications that didn’t lead to death were seen in 5.4%. In follow-up period 76.5% of patients were in American function class 1,and others were in function class 2 .Fac- tors that were related to mortality were general condition of the patients before op- eration, kind of operation, use of high dose Inotropic agent after operation, need of balloon pump usage, valve exchange in valve malfunction states, redo operation and pump time above 180 minutes and clump time above120 minutes . Conclusions: Emergency cardiac operations have a high mortality rate and the kind of operation and the general condition of the patient are the most predicted causes of mortality.