HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Scott B. Johnson James L. Nielsen Edward Y. Sako John H. Calhoon Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, S. B. Articles by Miller, O. L. Search for Related Content PubMed PubMed Citation Articles by Johnson, S. B. Articles by Miller, O. L.

Ann Thorac Surg 1995;60:117-121
© 1995 The Society of Thoracic Surgeons

---

Articles

Penetrating intrapericardial wounds: Clinical experience with a surgical protocol

Department of Cardiothoracic Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA

^* Address reprint requests to Dr Miller, Department of Cardiothoracic Surgery, University of Texas Hospital, The University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284-7841.
Presented at the Forty-first Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 10–12, 1994.

Background.: From 1972 to 1977, a treatment protocol was developed at our institution for patients with suspected penetrating intrapericardial wounds. It consists of immediate transport to the operating room, pericardial decompression by subxiphoid pericardial window under local or light general anesthesia in patients in stable condition, and median sternotomy and operative repair with limited use of cardiopulmonary bypass.

Methods.: The records of 79 consecutive patients with acute penetrating intrapericardial injury who underwent operation from March 1978 to July 1991 were reviewed. There were 59 patients (75%) with stab wounds and 20 (25%) with gunshot wounds. Wound location was as follows: right ventricle, 33 (42%); left ventricle, 28 (35%); multiple sites, 8 (10%); atrium, 5 (6%); and great vessels, 5 (6%).

Results.: Subxiphoid pericardial window was performed under local or light general anesthesia in 53 patients (67%). Cardiopulmonary bypass was required in only 4 patients. Overall mortality was 6%.

Conclusion.: Approach to a trauma victim must be systematic. We believe one treatment protocol for patients with suspected penetrating intrapericardial wounds is effective.

This article has been cited by other articles:

				F. M. de Andrade, O. M. A. Mourad, and L. F. Judice The victim of thoracic gunshot: Assessment of the patient and management of pulmonary artery bullet embolism. J. Thorac. Cardiovasc. Surg., July 1, 2010; 140(1): 254 - 254. [Full Text] [PDF]

				S. Aubert, O. S. Neto, A. Pawale, and G. D. Dreyfus Late Mitral Valve Regurgitation After Bullet Wound to the Heart Ann. Thorac. Surg., August 1, 2006; 82(2): 737 - 739. [Abstract] [Full Text] [PDF]

				A.J.H.A. Scholte, E.R. Holman, M.C.P. Haverkamp, D. Poldermans, E.E. van der Wall, R.A.E. Dion, and J.J. Bax Underestimation of severity of mitral regurgitation with varying hemodynamics Eur Heart J Cardiovasc Imaging, August 1, 2005; 6(4): 297 - 300. [Abstract] [Full Text] [PDF]

				V. S. Tayal, M. A. Beatty, J. A. Marx, C. A. Tomaszewski, and M. H. Thomason FAST (Focused Assessment With Sonography in Trauma) Accurate for Cardiac and Intraperitoneal Injury in Penetrating Anterior Chest Trauma J. Ultrasound Med., April 1, 2004; 23(4): 467 - 472. [Abstract] [Full Text] [PDF]

				J. B. McClurken, W. J. Hammer, and B. J. Lin Transcardiac gunshot wound recognized forty-eight years later J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 293 - 295. [Full Text] [PDF]

				R. Rawlins, A. Momin, D. Platts, and A. El-Gamel Traumatic cardiogenic shock due to massive air embolism. A possible role for cardiopulmonary bypass Eur J Cardiothorac Surg, November 1, 2002; 22(5): 845 - 846. [Abstract] [Full Text] [PDF]

				D. G. Harris, K. A. Papagiannopoulos, J. Pretorius, T. Van Rooyen, and G. J. Rossouw Current evaluation of cardiac stab wounds Ann. Thorac. Surg., December 1, 1999; 68(6): 2119 - 2122. [Abstract] [Full Text] [PDF]

				G. Babatasi, M. Massetti, S. Bhoyroo, O. Le Page, and A. Khayat Pulmonary artery bullet injury following thoracic gunshot wound Eur J Cardiothorac Surg, January 1, 1999; 15(1): 87 - 90. [Abstract] [Full Text] [PDF]

				J. M. Baker, F. D. Battistella, E. Kraut, J. T. Owings, and D. M. Follette Use of Cardiopulmonary Bypass to Salvage Patients With Multiple-Chamber Heart Wounds Arch Surg, August 1, 1998; 133(8): 855 - 860. [Abstract] [Full Text] [PDF]