Residual or Delayed Lesions from Penetrating Cardiac Wounds

¹ Joseph B. Whitehead Department of Surgery, Thoracic and Cardiovascular Surgery Division, Emory University School of Medicine, and Grady Memorial Hospital, Atlanta, Georgia

During an eight-year period, 76 patients with penetrating wounds of the heart were treated at our institution. Among the 56 patients who survived, there were 16 instances of delayed sequelae in 14 patients, an incidence of 25 percent. Residual sequelae from penetrating cardiac wounds may not be initially evident or detected because of the urgency when tamponade or bleeding are present or because of the low cardiac output state that may exist. For this reason and because delayed sequelae such as cardiac aneurysm may occur, close observation and repeat examination is required in patients who have sustained penetrating wounds. Because of the great variability of the hemodynamic significance of the intracardiac lesions and the similarity of the clinical signs between some of them, cardiac catheterization and angiocardiography should be performed, if at all possible, in order to define the type lesions and their hemodynamic significance before they are repaired.