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  • Title: [Principles for the treatment of cardiac injuries: a twenty-two year experience].
    Author: Keçeligil HT, Bahcivan M, Demirağ MK, Celik S, Kolbakir F.
    Journal: Ulus Travma Acil Cerrahi Derg; 2009 Mar; 15(2):171-5. PubMed ID: 19353321.
    Abstract:
    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. CONCLUSION: 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.
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