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The Annals of Thoracic Surgery, Vol 47, 250-253, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Penetrating wounds to the heart: a wartime experience

VA Jebara and B Saade
Division of Thoracic and Cardio-vascular Surgery, Hotel-Dieu de France, Universite Saint Joseph, Beirut, Lebanon.

Forty-nine war casualties with penetrating cardiac wounds were treated at the Hotel-Dieu de France University Hospital between April 1975 and December 1987. All the wounds were caused by high-velocity missiles. An aggressive approach was utilized. Emergency room thoracotomy was performed in 17 "lifeless" patients, 4 of whom survived. Twenty-seven of the 32 patients who were in stable enough condition to undergo initial repair in the operating room survived. Overall survival was 63% (31/49). No intracardiac injuries were diagnosed in survivors, and no cardiac reoperations were required. Careful analysis of the trajectory of the missile or missiles and a portable chest roentgenogram were the most important factors for diagnosing a penetrating wound to the heart and for predicting potential associated injuries.

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