Surgical Challenges for Urgent Approach in Penetrating Heart Injuries
The aim of this clinical study is to assess the characteristics of penetrating heart injury and its surgical challenges for urgent surgical approach.
Materials and Methods: Seventeen patients suffering from penetrating heart wounds were evaluated retrospectively in the department of cardiovascular surgery between 1996 and 2004. All patients were male, with ages ranging from 19 to 36 years, with a mean age of 23.6 ± 5 years.
Results: Median sternotomy, left anterior thoracotomy, and right anterior thoracotomy were performed to control the bleeding or to reach the heart for internal cardiac massage in 5, 11 and, 1 control, respectively. The right ventricle was the most commonly injured chamber (64.7%, n = 12), followed by left ventricle (17.7%, n = 4), and right atrium (17.6%, n = 3); a left atrial injury was not seen. Mortality rate was 29% (5 cases), and 12 controls were discharged without any complications.
Conclusion: Although the most important factor affecting mortality in penetrating heart injuries is rapid transport, an urgent approach applied by a specialist team can decrease potential mortality and morbidity rates.
Aaland MO, Bryan FC 3rd, Sherman R. 1994. Two-dimensional echocardiogram in hemodynamically stable victims of penetrating precordial trauma. Am Surg60:412-5.nAsensio JA, Roldan G, Petrone P, Forno F, Rowe V, Salim A. 2001. Cardiac trauma. Trauma3:69-77.nBeall AC Jr, Diethrich EB, Crawford HW, Cooley DA, De Bakey ME. 1966. Surgical management of penetrating cardiac injuries. Am J Surg112:686-92.nBoyd TF, Strieder JW. 1965. Immediate surgery for traumatic heart disease. J Thorac Cardiovasc Surg50:305-15.nBuckman RF Jr, Badellino MM, Mauro LH, et al. 1993. Penetrating cardiac wounds: prospective study of factors influencing initial resuscitation. J Trauma34:717-27.nCampbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. 1997. Review of 1198 cases of penetrating cardiac trauma. Br J Surg84:1737-40.nCingoz F, Bingol H, Kuralay E, Demirkilic U, Tatar H. 2006. Coronary artery revascularization without cardiopulmonary bypass after a cardiac stab wound. Internet Journal of Thoracic and Cardiovascular Surgery 8(1).nCingoz F, Bingol H, Kuralay E, Tatar H. 2007. A concealed penetrating cardiac injury. J Card Surg22:350-2.nCullford AT. 1989. Penetrating cardiac injuries. Hood RM, Boyd AD, Cullitbrd AT, eds. Thoracic Trauma. Philadelphia: WB Sauders; 78-210.nFrank MJ, Nadimi M, Lesniak LJ, Hilmi KI, Levinson GE. 1971. Effects of cardiac tamponade on myocardial performance, blood flow, and metabolism. Am J Physiol220:179-85.nGoins WA, Ford DH. 1996. The lethality of penetrating cardiac wounds. Am Surg62:987-93.nLorenz HP, Steinmetz B, Lieberman J, Schecoter WP, Macho JR. 1992. Emergency thoracotomy: survival correlates with physiologic status. J Trauma32:780-5.nMoreno C, Moore EE, Majune JA, Hopeman AR. 1986. Pericardial tamponade: a critical determinant for survival following penetrating cardiac wounds. J Trauma26:821-5.nMillham FH, Grindlinger GA. 1993. Survival determinants in patients undergoing emergency room thoracotomy for penetrating chest injury. J Trauma34:332-6.nThourani VH, Feliciano DV, Cooper WA, et al. 1999. Penetrating cardiac trauma at an urban trauma center: a 22-year perspective. Am Surg65:811-6.n
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