Penetrating Cardiac Injury

Abstract

Management of penetrating cardiac injuries continues to be a challenge despite considerable improvement in healthcare facilities. The patient who reaches the hospital alive is usually in agony. The key to good outcome is prompt recognition of injuries, urgent surgical intervention and intensely monitored postoperative care. In patients with recent or impending cardiac arrest, resuscitative thoracotomy in emergency room is the only hope for survival. The poor outcome generally ascribed to the procedure is related to the cardiac injury itself. We report the management of a patient whose heart was lacerated by a motorized saw. This patient went into cardiac arrest upon arrival in emergency room. Resuscitative thoracotomy was performed in emergency room and his right ventricle was repaired successfully. The patient survived but suffered from ischaemic cerebral encephalopathy. The purpose of reporting this case is to highlight the role of early resuscitative thoracotomy in patients with impending or recent cardiac arrest due to penetrating cardiac trauma. The reported low survival should not deter the surgeon from attempting this procedure which can be life saving in a selected group of patients.