title: Surgical challenges for urgent approach in penetrating heart injuries.
abstract: The aim of this clinical study is to assess the characteristics of penetrating heart injury and its surgical challenges for urgent surgical approach.
  
  
  METHODS
  Seventeen patients suffering from penetrating heart wounds were evaluated retrospectively in the department of cardiovascular surgery between 1996 and 2004. All patients were male, with ages ranging from 19 to 36 years, with a mean age of 23.6 +/- 5 years.
  
  
  RESULTS
  Median sternotomy, left anterior thoracotomy, and right anterior thoracotomy were performed to control the bleeding or to reach the heart for internal cardiac massage in 5, 11 and, 1 control, respectively. The right ventricle was the most commonly injured chamber (64.7%, n = 12), followed by left ventricle (17.7%, n = 4), and right atrium (17.6%, n = 3); a left atrial injury was not seen. Mortality rate was 29% (5 cases), and 12 controls were discharged without any complications.
  
  
  CONCLUSIONS
  Although the most important factor affecting mortality in penetrating heart injuries is rapid transport, an urgent approach applied by a specialist team can decrease potential mortality and morbidity rates.
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Celalettin
authors.initials: C
authors.lastname: Gunay
authors.forename: Faruk
authors.initials: F
authors.lastname: Cingoz
authors.forename: Erkan
authors.initials: E
authors.lastname: Kuralay
authors.forename: Ufuk
authors.initials: U
authors.lastname: Demirkilic
authors.forename: Harun
authors.initials: H
authors.lastname: Tatar
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004630:Emergencies; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000601:surgery*