Penetrating left ventricular injuries management: single General Thoracic Center experience

• Published in: General thoracic and cardiovascular surgery Vol. 69; no. 8; pp. 1254 - 1257
• Main Authors: Campisi, Alessio, Ciarrocchi, Angelo Paolo, Grani, Giorgio, Argnani, Desideria, Salvi, Maurizio, Stella, Franco
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-08-2021; Springer Nature B.V
• Subjects: Blood pressure; Cardiac Surgery; Cardiology; Case Report; Emergency medical care; Glasgow Coma Scale; Heart rate; Heart surgery; Hemodynamics; Hospitals; Injuries; Length of stay; Medical prognosis; Medicine; Medicine & Public Health; Mortality; Oxygen saturation; Patients; Pericardium; Surgeons; Surgical Oncology; Sutures; Thoracic Surgery; Trauma; Trauma centers; Ultrasonic imaging; Penetrating trauma; Heart injury; Left ventricle; Stab wound
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-021-01650-0

Background
Left ventricular penetrating injuries are rare but often lethal. Transport times greater than 30 min have been shown to increase the injury severity; thus early recognition of cardiac tamponade, prompt pericardial decompression, and control of cardiac hemorrhage are mandatory.
Methods
We retrospectively reviewed our record to include patients with penetrating trauma of the heart.
Results
Four hemodynamically unstable young male patients with left ventricular penetrating injury of the heart were referred to our unit between January 2007 and December 2015. Median time from trauma to surgery was 16 min (range 14–21). A cardiorrhaphy through sternotomy with no extracorporeal support was performed. We had no in-hospital mortality.
Conclusion
According to our experience, in patients with hemodynamic shock and penetrating cardiac injury, a timely recognition of injuries and referral to the closest thoracic surgery unit may increase patient survival if it is located closer than a level I trauma center.