Penetrating injury to the heart requiring cardiopulmonary bypass: a case study.

Penetrating wounds to the heart represent a significant surgical challenge because of their unique clinical course and the need for emergent operative care. This operative care, which may include cardiopulmonary bypass (CPB), must be initiated in a prompt yet careful fashion to optimize outcome, while minimizing morbidity. Trauma, because of its unpredictable and non-routine nature, may present many challenges to the perfusionist in an attempt to anticipate surgical needs and requirements. In this case report, we describe the successful surgical repair of a cardiac nail gun injury, as well as strategies we feel are essential for the safe, successful, and timely application of emergent CPB.