title: Low-Velocity Nail-Gun Injuries to the Interventricular Septum: Report of Two Cases, One in a Child.
abstract: Nail-gun injury to the heart is rare. Nail-gun injury to the interventricular septum is rarer: we could find only 5 reported cases, and none involving a child. We report 2 additional cases, in which nails penetrated the interventricular septum without causing acute pericardial tamponade, heart block, or shunt across the septum. Transesophageal echocardiography provides a dynamic way to evaluate the patient preoperatively, intraoperatively, and postoperatively. In the cases reported here, both the adult with multiple interventricular nails and the child with a single nail underwent foreign-object removal via median sternotomy. The child needed cardiopulmonary bypass for removal of the nail. There were no short-term or long-term sequelae from these interventricular septal injuries.
authors.forename: Kara L
authors.initials: KL
authors.lastname: Michalsen
authors.forename: John P
authors.initials: JP
authors.lastname: Iguidbashian
authors.forename: James P
authors.initials: JP
authors.lastname: Kyser
authors.forename: William B
authors.initials: WB
authors.lastname: Long
mesh_terms: D000059:Accidents; D000328:Adult; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005547:Foreign Bodies / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006335:Heart Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D056346:Sternotomy; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
keywords: Adenosine; construction materials/nail gun; echocardiography, transesophageal; foreign bodies/ultrasonography; heart injuries/diagnosis/surgery; interventricular septum; suicide, attempted; wounds, penetrating/surgery