Original article
Penetrating cardiac injuries

https://doi.org/10.1016/0003-4975(91)90110-CGet rights and content

Abstract

One hundred nine penetrating cardiac injuries were reviewed: 49 gunshot wounds and 60 stab wounds. They were classified into four groups: group 1 (lifeless), 38; group 2 (agonal), 16; group 3 (shock), 33; and group 4 (stable), 22. Thirty-six patients in group 1 (94%) and 8 of 16 patients in group 2 (50%) underwent emergency room thoracotomy; 24 of 33 in group 3 (73%) and 20 of 22 (90%) underwent thoracotomy in the operating room. Twentyone (38%) of 55 patients undergoing emergency room thoracotomy survived, whereas 47 (87%) of 54 patients undergoing operating room thoracotomy survived. Survival was 12 of 38 (31%) in group 1, 11 of 16 (69%) in group 2, 26 of 33 (79%) in group 3, and 18 of 22 (82%) in group 4 with an overall survival of 67 of 109 (61%). Gunshot wounds of the heart portend a worse prognosis than stab wounds. Survival of gunshot wounds was 20 of 49 (40%) compared with 47 survivors of 60 stab wounds (78%). Aggressive treatment, including emergency room thoracotomy, is justified for lifeless and deteriorating cardiac injury victims.

References (6)

  • RR Ivatury et al.

    Penetrating cardiac trauma: quantifying the severity of anatomic and physiologic injury

    Ann Surg

    (1987)
  • EE Moore et al.

    Penetrating abdominal trauma index

    J Trauma

    (1981)
  • RR Ivatury et al.

    Emergency room thoracotomy for the resuscitation of patients with fatal penetrating injuries of the heart

    Ann Thorac Surg

    (1981)
There are more references available in the full text version of this article.

Cited by (91)

  • Resuscitative thoracotomy

    2023, Current Therapy of Trauma and Surgical Critical Care
  • Cardiac injuries

    2023, Current Therapy of Trauma and Surgical Critical Care
  • Penetrating cardiac trauma caused by a nail-gun: A case report and narrative review

    2022, Trauma Case Reports
    Citation Excerpt :

    Patients with penetrating nail-gun injuries to the chest require urgent imaging. Bedside transthoracic echocardiography (TTE) is useful in determining the presence of a pericardial effusion, cardiac tamponade or in rare cases, valvular involvement [17,19,25]. Nails can be up to 6 cm long with unclear, trajectories, and can hence involve multiple structures.

  • Great Vessel and Cardiac Trauma

    2009, Surgical Clinics of North America
    Citation Excerpt :

    After cardiac repair, a thorough exploration of the rest of the mediastinum should be performed, including visualization of the pleural spaces, posterior pericardium, and, specifically, the mammary arteries, which are often injured but are in spasm and may not be actively bleeding. During the past 30 years, the reported outcomes after treatment of penetrating cardiac injuries have been variable.112–116 Multiple factors account for this variability, including differing transport systems, extent and mechanism of injury, and the presence of other associated injuries.

View all citing articles on Scopus

Presented at the Thirty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Dorado, Puerto Rico, Nov 8–10, 1990.

View full text