Penetrating injuries of the heart

Abstract

Thirty consecutive patients with penetrating cardiac wounds were treated surgically during a period of 6.5 years. There were 6 deaths, giving a survival rate of 80 per cent. Delay in undertaking repair was associated with a friable myocardium. Cardiac arrest, either before or during operation, occurred in 5 patients, 4 of whom subsequently died. Left ventricular wounds were associated with a higher mortality than those affecting the right ventricle. Perforating cardiac injuries had a mortality of 43 per cent in comparison with 13 per cent for penetrating injuries. Coexistent intraperitoneal injuries were present in 4 patients, 2 of whom underwent successful repair.

Experience in the management of 50 consecutive penetrating wounds of the heart

“…This is consistent with the reports in the literature (Neville et al, 1971). Rasaretnam, however, has reported a higher mortality with left ventricular injuries (Rasaretnam and Paul, 1974). The mortality rate is high in group A regardless of the type of injury.…”

“…This approach to therapy has also been advocated by others (Isaacs, 1959;Beall et al, 1961). In recent years, the trend has shifted to more aggressive treatment (Yao et al, 1968;Borja et al, 1970;Beall et al, 1972;Anagnostopoulos and Kittle, 1973;Bolanowski et al, 1973;Rasaretnam and Paul, 1974;Maynard et al, 1975). Despite early surgical intervention, the mortality rate remains inordinately high.…”