[Principles for the treatment of cardiac injuries: a twenty-two year experience].
BACKGROUND
Penetrating cardiac injuries have a rather high mortality and require a rapid diagnosis and emergency surgical intervention. The aim of this study was to present and discuss our experience with penetrating heart wounds.


METHODS
Sixteen patients with penetrating cardiac injury underwent surgical treatment at the Department of Cardiovascular Surgery between 1985-2007. The patients ranged in age from 6 to 71 years (mean age 45.1 years). The cause of cardiac injury was stab wounds in 8 patients (50%), iatrogenic reasons in 6 patients (37.5%) and shotgun wounds in 2 patients (12.5%).


RESULTS
Exposure to the heart was accomplished by a median sternotomy in 12 patients (75%) and a left-sided anterolateral thoracotomy in 4 patients (25%). The right ventricle (RV) was injured in 7 patients (43.75%), left ventricle (LV) in 3 patients (18.75%), left atrium (LA) in 1 patient (6.25%), LV+LA in 1 patient (6.25%), and coronary arteries in 4 patients (25%). Cardiac wounds were treated by simple suture technique over Teflon or pericardial pledgets in all patients. Two patients died in the early postoperative period.


CONCLUSIONS
The basis for successful management of penetrating cardiac trauma is effective resuscitative measures followed by early detection and definition and emergency surgical treatment of the injury.
Keçeligil
Hasan Tahsin
HT
Department of Cardiovascular Surgery, Ondokuz Mayis University, Samsun, Turkey. htkeceligil@yahoo.com
Bahcivan
Muzaffer
M
Demirağ
Mustafa Kemal
MK
Celik
Serkan
S
Kolbakir
Ferşat
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D013249:Sternum / Q000601:surgery; D013908:Thoracotomy; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D014951:Wounds, Stab / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D055815:Young Adult