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Ann Thorac Surg 1989;47:250-253
© 1989 The Society of Thoracic Surgeons

Articles

Penetrating wounds to the heart: a wartime experience

Victor A. Jebara, MD*, Bechir Saade, MD

Division of Thoracic and Cardiovascular Surgery, Hôtel-Dieu de France, Université Saint Joseph, Beirut, Lebanon, France

Accepted for publication August 16, 1988.

* Address reprint requests to Dr Jebara, 3 rue Monge, 92170 Vanves, France.

Forty-nine war casualties with penetrating cardiac wounds were treated at the Hôtel-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% ([equation]). 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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