Pulmonary Artery Bullet Embolism following Cardiac Gunshot Wound

• Published in: Annals of vascular surgery Vol. 36; pp. 290.e11 - 290.e14
• Main Authors: Imbert, Pierre-Yves, Goin, Géraldine, Goudard, Yvain, De La Villéon, Bruno, Bonnet, Pierre-Mathieu, Sockeel, Philippe, Pauleau, Ghislain
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-10-2016
• Subjects: Cardiac Surgical Procedures; Computed Tomography Angiography; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - etiology; Heart Injuries - diagnostic imaging; Heart Injuries - etiology; Heart Injuries - surgery; Humans; Male; Middle Aged; Pulmonary Artery - diagnostic imaging; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - etiology; Surgery; Time Factors; Treatment Outcome; Wounds, Gunshot - complications; Wounds, Gunshot - diagnostic imaging; Wounds, Gunshot - surgery
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2016.02.038

Penetrating chest trauma is common but few need surgical treatment (10–20%). The mortality of gunshot wounds of the heart is 45%, among the wounded arriving at the hospital. The suspicion of wound heart with an inlet in the heart area (limited by costal awnings down, clavicles top, and mid-clavicular line outside) and pericardial effusion remains a surgical indication. Gunshot wounds of the heart with migration of the projectile in the pulmonary artery are rare. Migration of projectile into the pulmonary artery is described most often with lesions of peripheral veins without concomitant cardiac involvement. The indication of projectile extraction is not clearly defined in the literature. Conservative management of selected cases of pulmonary artery bullet emboli may be warranted in light of the risks of extraction.