Quantum leap forward in the management of cardiac trauma: The pioneering work of Dwight E. Harken

Transfixing cardiac injury with perforations in stomach, diaphragm and lung: unusual scenario in penetrating trauma

“…The heart, a vital organ protected by the thoracic cage, rarely suffers penetrating injuries. Penetrating cardiac injuries had been considered lethal for centuries, with sporadic clinical observations suggesting possible survival, until in 1896 Rehn demonstrated the feasibility of suturing a heart wound [ 4 ] . Nevertheless, it was Harken who during World War II, compiled an impressive number of 130 soldiers operated on due to cardiac lesions by shrapnel, with no deaths recorded [ 4 ] .…”

“…Penetrating cardiac injuries had been considered lethal for centuries, with sporadic clinical observations suggesting possible survival, until in 1896 Rehn demonstrated the feasibility of suturing a heart wound [ 4 ] . Nevertheless, it was Harken who during World War II, compiled an impressive number of 130 soldiers operated on due to cardiac lesions by shrapnel, with no deaths recorded [ 4 ] . In Brazil, the first successful sutures of a cardiac injury were performed by Brauner in 1927, and Zerbini in 1942, who operated on a 6-year-old boy who was hit by metallic shrapnel in the precordium and suffered an injury in the anterior descending coronary artery, marking the first steps of Brazilian heart surgery [ 5 , 6 ] .…”

An odyssey of suturing cardiac wounds: Lessons from the past

“…Blalock and Ravitch 9 published in 1943 the use of pericardiocentesis to deal with cardiac wounds in soldiers, but it is truly Dwight Harken who revolutionized this dreadful management. Harken was called to duty as a consultant thoracic surgeon and he reported in 1946 an impressive experience that clearly inspired surgeons regarding the development of cardiac surgery 10 . Indeed, over a 10‐month period, Harken removed 78 missiles that were within or in proximity to the great vessels; he extracted 56 foreign bodies from the heart, 13 of them from the cardiac cavities.…”

The Odyssey of suturing cardiac wounds: lessons from the past.

“…Blalock and Ravith published in 1943 the use of pericardiocentesis to deal with cardiac wounds in soldiers but it is truly Dwight Harken who revolutionized this dreadful management [9]. Harken was called to duty as a consultant thoracic surgeon and he reported in 1946 an impressive experience that clearly inspired surgeons regarding the development of cardiac surgery [10]. Indeed, over a 10 months period, Harken removed 78 missiles that were within or in proximity to the great vessels; he extracted 56 foreign bodies from the heart, 13 of them from the cardiac cavities!…”