Penetrating wounds of the heart: an analysis of 61 cases.
OBJECTIVE: To present the managing experience of the patients with penetrating cardiac injuries for improving the treatment outcome. METHODS: The data of 61 cases with penetrating wounds of the heart were retrospectively studied, and the study covered a period of 11 years. RESULTS: In this series, stab wounds accounted for 61 cases (84%), among which, 9 cases with stable hemodynamics were managed conservatively, and the rest 52 underwent thoracotomy. The amount of preoperative infusion was less than 1000 ml in 65% of the latter cases. Only in two patients, preoperative pericardiocentesis was done, yielding false negative in one. Four cases sustaining cardiac arrest soon after arrival were subjected to emergency thoracotomy resulting in three survivals. Among 52 patients undergoing surgery, two deaths occurred after operation from associated abdominal injuries or failure of cerebral resuscitation. In the present series of 61 cases, the overall survival rate was 96.7%. CONCLUSIONS: Early establishment of diagnosis and prompt thoracotomy are the fundamental factors affecting the outcome of penetrating cardiac injuries. Preoperative massive transfusion and pericardiocentesis are not advocated.
Gao
Jinmou
J
Department of Traumatology and Cardiothoracic Surgery, Chongqing Emergency Medical Center, Chongqing 400014, China.