Cardiac penetrating injuries: personal experience of 45 cases.

This study represents the personal experience of the author, in 45 cases of penetrating cardiac wounds. Eleven patients with no signs of life had surgical intervention on the stretcher in the emergency room (ER). One patient survived (mortality 91 per cent). Thirty-four patients were operated on in the operating theatre (OT) with a mortality rate of 12 per cent. The clinical triad of a low blood pressure, high central venous pressure (CVP) and distant cardiac sounds, proved diagnostic in 82 per cent of the patients with cardiac tamponade. Pulsus paradoxus was found in only 7 per cent of tamponade cases. Pericardiocentesis seems to have little value in diagnosing or treating tamponade. The most commonly injured cardiac chamber was the right ventricle (RV) (36 per cent). Coronary artery damage occurred in 4 cases with a mortality of 75 per cent. Aspiration of the ventricles for air embolism was performed in all 16 cases who arrested during operation. A significant volume of air was aspirated in 4 (25 per cent). Early intervention saved three of them.