TY  - JOUR
PY  - 1992//
TI  - Penetrating cardiac trauma: management strategy based on 129 surgical emergencies over 2 years
JO  - Annals of thoracic surgery
A1  - Knott-Craig, C. J.
A1  - Dalton, R. P.
A1  - Rossouw, G. J.
A1  - Barnard, P. M.
SP  - 1006
EP  - 1009
VL  - 53
IS  - 6
N2  - Between 1986 and 1988, 129 patients with stab wounds to the heart were referred from the emergency room of our institution for a thoracic surgical procedure. Multiple entrance wounds of the heart were present in 12 patients, and through-and-through stab wounds were encountered in another 10. The overall hospital mortality rate was 8.5% (11/129), which includes a 54% mortality rate for the 13 patients undergoing emergency room thoracotomy. These patients were pulseless and unconscious either on arrival (n = 8) or soon thereafter (n = 5). Cardiopulmonary bypass was not used during the primary operation, although 7 patients underwent subsequent intracardiac repair with bypass without hospital mortality. Important aspects of our preoperative management strategy include: (1) aggressive transfusion to improve the central venous pressure/intrapericardial pressure gradient; (2) rapid drainage of the pleural and pericardial spaces to reduce intrapericardial pressure; (3) empirical partial correction of metabolic acidosis with sodium bicarbonate; and (4) emergency operation without unnecessary cardiac imaging. Patients suspected of having penetrating cardiac trauma and cardiac tamponade are best managed by aggressive primary intervention and immediate operation.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4975
UR  - http://dx.doi.org/
ID  - ref1
ER  -