title: Penetrating wounds to the heart: a wartime experience.
abstract: Forty-nine war casualties with penetrating cardiac wounds were treated at the Hôtel-Dieu de France University Hospital between April 1975 and December 1987. All the wounds were caused by high-velocity missiles. An aggressive approach was utilized. Emergency room thoracotomy was performed in 17 "lifeless" patients, 4 of whom survived. Twenty-seven of the 32 patients who were in stable enough condition to undergo initial repair in the operating room survived. Overall survival was 63% (31/49). No intracardiac injuries were diagnosed in survivors, and no cardiac reoperations were required. Careful analysis of the trajectory of the missile or missiles and a portable chest roentgenogram were the most important factors for diagnosing a penetrating wound to the heart and for predicting potential associated injuries.
authors.affiliation: Division of Thoracic and Cardio-vascular Surgery, Hôtel-Dieu de France, Université Saint Joseph, Beirut, Lebanon.
authors.forename: V A
authors.initials: VA
authors.lastname: Jebara
authors.forename: B
authors.initials: B
authors.lastname: Saade
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D014857:Warfare; D014950:Wounds, Penetrating / Q000401:mortality / Q000473:pathology / Q000601:surgery*