Background

Left ventricular penetrating injuries are rare but often lethal. Transport times greater than 30 min have been shown to increase the injury severity; thus early recognition of cardiac tamponade, prompt pericardial decompression, and control of cardiac hemorrhage are mandatory.

Methods

We retrospectively reviewed our record to include patients with penetrating trauma of the heart.

Results

Four hemodynamically unstable young male patients with left ventricular penetrating injury of the heart were referred to our unit between January 2007 and December 2015. Median time from trauma to surgery was 16 min (range 14–21). A cardiorrhaphy through sternotomy with no extracorporeal support was performed. We had no in-hospital mortality.

Conclusion

According to our experience, in patients with hemodynamic shock and penetrating cardiac injury, a timely recognition of injuries and referral to the closest thoracic surgery unit may increase patient survival if it is located closer than a level I trauma center.

中文翻译：

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穿透性左心室损伤管理：单一的普通胸科中心经验

背景

左心室穿透性损伤很少见，但通常是致命的。超过 30 分钟的运输时间已被证明会增加伤害的严重程度；因此，早期识别心脏压塞、及时进行心包减压和控制心脏出血是必须的。

方法

我们回顾性地审查了我们的记录，包括心脏穿透性创伤的患者。

结果

2007 年 1 月至 2015 年 12 月期间，四名血流动力学不稳定且左心室穿通伤的年轻男性患者被转诊到我们单位。从创伤到手术的中位时间为 16 分钟（范围 14-21）。在没有体外支持的情况下通过胸骨切开术进行了心脏造影。我们没有院内死亡。

结论

根据我们的经验，对于血流动力学休克和穿透性心脏损伤的患者，如果距离 I 级创伤中心更近，及时识别损伤并将其转诊至最近的胸外科可能会增加患者的存活率。