A unique nail gun injury to the heart with a delayed presentation

Jodati, Ahmadreza; Safaei, Naser; Toufan, Mehrnoush; Kazemi, Babak

doi:10.1510/icvts.2011.272120

Cited by 18 publications

(29 citation statements)

References 8 publications

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“…1 Since then, only 3 American cases involving the IVS have been published. [2][3][4] In 1964, Zverev 8 reported (in Russian) one case of nail-gun injury to the heart of a child.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, there have been only 5 reported cases of penetration of the cardiac interventricular septum (IVS), and none of those has involved a child. [1][2][3][4][5] We describe 2 additional cases of nail-gun injuries through the IVS. One case involved an accidental self-inflicted wounding of a child, who needed removal of the nail during cardiopulmonary bypass (CPB).…”

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confidence: 99%

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Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

Michalsen¹,

Iguidbashian²,

Kyser³

et al. 2015

Texas Heart Institute Journal

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Nail-gun injury to the heart is rare. Nail-gun N ail-gun injury to the heart is rare. Nail guns usually cause injuries to the extremities. To the best of our knowledge, there have been only 5 reported cases of penetration of the cardiac interventricular septum (IVS), and none of those has involved a child. 1-5We describe 2 additional cases of nail-gun injuries through the IVS. One case involved an accidental self-inflicted wounding of a child, who needed removal of the nail during cardiopulmonary bypass (CPB). In the adult, we used adenosine to slow the heart rate in order to extract 3 nails before performing a median sternotomy to suture entrance wounds in the right ventricle (RV). All nails were removed under transesophageal echocardiographic (TEE) guidance. Case Reports Patient 1In March 2012, a 3-year-old Russian immigrant picked up a pneumatic nail gun and accidentally shot himself in the chest. He walked over to his mother and reported that his chest hurt. His mother noticed a small puncture wound in the left parasternal area and took him in the family car to a local emergency department.Vital signs on arrival were a systolic blood pressure of 128 mmHg, a heart rate of 128 beats/min, a respiratory rate of 20 breaths/min, and pulse oximetry of 98% on room air. Physical examination produced normal results except for a small left parasternal puncture wound in the 5th intercostal space. A portable chest radiograph revealed a nail 3.81 cm in length, penetrating the left chest and possibly entering the left atrium (Fig. 1). The patient was transferred to our trauma center.Upon arrival, the boy was taken directly to the operating room. The patient showed no clinical signs of pericardial tamponade. Under general anesthesia, he underwent an intraoperative TEE, which showed the nail traversing the mid RV, crossing the ventricular septum, and entering the left ventricular (LV) chamber. The tip of the nail lay adjacent to the LV free wall and limited the movement of the mitral valve cord apparatus, causing mild mitral regurgitation. There was a suggestion of a patent foramen ovale.Through a median sternotomy, we performed a pericardiotomy and removed a small amount of dark blood. The head of the nail was not visible. Using two 6-0 Prolene traction sutures, we probed the epicardial entry wound; the nail was too Case Reports

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“…1 Since then, only 3 American cases involving the IVS have been published. [2][3][4] In 1964, Zverev 8 reported (in Russian) one case of nail-gun injury to the heart of a child.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

Michalsen¹,

Iguidbashian²,

Kyser³

et al. 2015

Texas Heart Institute Journal

View full text Add to dashboard Cite

show abstract

“…In Norway, this type of injury is obviously less common but still existing [37-39]. Knife is the most common weapon for stab injuries, followed by other sharp items such as screwdrivers [34], ice picks [19], chopsticks, pneumatic nailgun nails [14,20,40] but also curiosities as barb from a sting ray [28]. Fractured ribs or sternum are also reported to cause cardiac penetration [41].…”

Section: Discussionmentioning

confidence: 99%

“…Fractured ribs or sternum are also reported to cause cardiac penetration [41]. Pneumatic nails might be shot without the patient noticing and cause surprise when detected by CT scan or eccocardiography imbedded in the heart [14,20]. The iatrogenic penetrations of the heart due to different medical devices (pacemaker leads, intracoronary stents, Amplatzer devices) are not discussed in this paper.…”

Section: Discussionmentioning

confidence: 99%

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How to mend a broken heart: a major stab wound of the left ventricle

Kaljusto

Tønnessen

2012

World J Emerg Surg

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A 28-year-old male admitted with a stab wound under his left nipple, underwent emergency surgery because of confusion, a decreasing blood pressure and increasing tachycardia. A median sternotomy incision was made and after establishing cardiopulmonary bypass, a 7 cm wound in the left ventricle and a smaller wound in the left atrium were repaired. An injured segment of lung was resected and the left anterior descending and circumflex arteries were grafted after weaning from cardiopulmonary bypass was initially unsuccessful. Although the patient suffered a stroke, probably due to prehospital hypoperfusion, he eventually recovered without major sequelae. In addition to the case report we present a literature review of the last 15 years pertaining the management of penetrating cardiac injury.

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Penetrating nail‐gun injury of the thoracic descending aorta

Yamamoto

Umeda

Kamei

et al. 2020

Acute Medicine & Surgery

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Penetrating nail-gun injury of the thoracic descending aorta Dear Editor, Penetrating aortic injuries are uncommon and highly lethal, and extremely few patients make it to the hospital alive. Here, we describe a rare case of penetrating aortic injury from accidental discharge of a nail gun. A 44-year-old man was brought to the emergency department of a local hospital because of an accidental nail-gun injury to the chest. Chest radiography revealed a 9-cm nail in the left chest and mediastinum (Fig. 1A). He was transferred to our hospital for further treatment. On admission, he was found to be completely alert, blood pressure was 90/ 60 mmHg, heart rate was 110 b.p.m., and blood oxygen saturation was 97% on room air. There was an entry wound in the left anterior chest wall but no exit wound. Chest computed tomography revealed a foreign body that had penetrated the anterior chest wall, left lung, and anterior and

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A unique nail gun injury to the heart with a delayed presentation

Cited by 18 publications

References 8 publications

Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child

How to mend a broken heart: a major stab wound of the left ventricle

Penetrating nail‐gun injury of the thoracic descending aorta

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