title: Traumatic left ventricular free-wall laceration by a gunshot: report of a case.
abstract: This report describes the case of a 47-year-old man who shot himself in the left side of the chest in an attempted suicide, and was transferred to the hospital. Two gunshot wounds were found in the left side of the chest and the back. CT scans revealed left hemopneumothorax, the accumulation of pericardial blood, and lacerations of the heart and the spleen. Emergency thoracotomy and laparotomy were performed. There was a contusion of the left lung and lacerations of the left ventricular free wall, the diaphragm, and the spleen. The laceration of the heart was repaired by 3 pairs of mattress sutures with felt strips, and covered with fibrin glue and a TachoComb(®) tissue sealing sheet without the use of cardiopulmonary bypass. The patient was discharged on foot on the 18th postoperative day. Such patients can only be saved with an efficient emergency medical-care system including quick transportation, and close cooperation of the hospital staff.
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Yokohama City Seibu Hospital, St. Marianna University, Yasashicho 1197-1, Asahi-ku, Yokohama, Kanagawa, 241-0811, Japan, takamaros@gmail.com.
authors.forename: Takamaro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Takafumi
authors.initials: T
authors.lastname: Wada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Funaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.forename: Ippei
authors.initials: I
authors.lastname: Seki
authors.forename: Shohei
authors.initials: S
authors.lastname: Imaki
authors.forename: Akeo
authors.initials: A
authors.lastname: Nakazawa
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D004632:Emergency Medical Services; D015718:Fibrin Tissue Adhesive; D006352:Heart Ventricles / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted; D013536:Suture Techniques; D014187:Transportation of Patients; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000601:surgery*
chemical_list: D015718:Fibrin Tissue Adhesive