Penetrating cardiac injury

Penetrating cardiac trauma caused by a nail-gun: A case report and narrative review

“…Patients who have unstable presentations to a peripheral centre may be temporized with a pericardial drain or fluid resuscitation, and when in extremis , require an emergency room thoracotomy [12] , [14] . Patients who are stable enough require prompt transfer to a centre with cardiothoracic and trauma expertise [12] , [14] , [27] . In terms of approach, a median sternotomy provides excellent exposure to the heart and mediastinal structures.…”

Nail Gun to the Heart—Patch Repair of Penetrating Cardiac Injury

“…Prior medical literature states that CPB is not effective in the management of penetrating cardiac injuries, given the time taken to place the patient on CPB and the required blood thinners. 3 However, in a retrospective review, Baker and Battistella et al state that CPB should be initiated immediately when given certain anatomical and physiological considerations. 3 Our patient required CPB, given continued hemorrhage during surgery and the need for definitive repair.…”

“…2 Furthermore, nail-gun injuries to the chest, classified as penetrating thoracic traumas, can cause major cardiovascular injury. Penetrating cardiac injuries most commonly wound the right ventricle because of its anterior position within the chest 3 and have mortality rates of about 25 per cent, similar to that of lowvelocity penetrating injuries. 4 Although dependant on the severity of symptoms and hemodynamic status, most patients with penetrating cardiac injury from nail guns require emergency operation with foreign body removal and simple, pledgeted suture repair.…”

“…3 However, in a retrospective review, Baker and Battistella et al state that CPB should be initiated immediately when given certain anatomical and physiological considerations. 3 Our patient required CPB, given continued hemorrhage during surgery and the need for definitive repair. Based on prior literature, our patient was a good candidate for CPB because of his lack of prior cardiac medical history and quick initiation of CPB protocol on surgical intervention.…”