Management of Stab Wounds of the Heart: Analysis of 73 Cases in 10 Years

Gwely, Noureldin Noaman; Mowafy, Ahmed; Khalaf, Salah; Amer, Saeed; Hamza, Usama; Elsaeed, Mohamed

doi:10.1055/s-0029-1240921

Cited by 6 publications

(11 citation statements)

References 16 publications

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“…Gwely, et al . (2010),[18] from Mansoura Medical School; Egypt, reported a series of 73 stab heart cases. Of these cases, 94.5% were males.…”

Section: Discussionmentioning

confidence: 99%

“…Those who needed cardiopulmonary resuscitation had mortality rate of 68.2%) and ER thoracotomy carried had a mortality rate of 66.7%). [1819]…”

Section: Discussionmentioning

confidence: 99%

“…Four patients died due to perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation. [18]…”

Section: Discussionmentioning

confidence: 99%

“…They also found the survival of penetrating injuries better than blunt chest injuries and stabs better than gun shots. [18–22]…”

Section: Discussionmentioning

confidence: 99%

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Emergency thoracotomies: Two center study

Sersar

Alanwar

2013

J Emerg Trauma Shock

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Introduction and Aim:Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors.Patients and Methods:Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis.Results:Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures.Conclusion:The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support. Emergency thoracotomy has an important role in emergency big volume hospitals and can save a lot of lives. Outcome can be improved by increasing the learning curve and the integrated cooperation of the emergency and surgical teams.

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“…Gwely, et al . (2010),[18] from Mansoura Medical School; Egypt, reported a series of 73 stab heart cases. Of these cases, 94.5% were males.…”

Section: Discussionmentioning

confidence: 99%

“…Those who needed cardiopulmonary resuscitation had mortality rate of 68.2%) and ER thoracotomy carried had a mortality rate of 66.7%). [1819]…”

Section: Discussionmentioning

confidence: 99%

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Emergency thoracotomies: Two center study

Sersar

Alanwar

2013

J Emerg Trauma Shock

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“…Our patient did not suffer from cardiac tamponade as there was a large opening to the left pleural cavity through the wound in the pericardium. This probably saved his life, although profound hypovolemia can conceal signs of cardiac tamponade leading to delayed diagnosis [36]. However, cardiac tamponade in the reviewed studies is not a prognostic factor regarding survival [2,33].…”

Section: Discussionmentioning

confidence: 99%

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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