PT - JOURNAL ARTICLE AU - Chad G. Ball AU - Alex Lee AU - Matthew Kaminsky AU - S. Morad Hameed TI - Technical considerations in the management of penetrating cardiac injury AID - 10.1503/cjs.008521 DP - 2022 Sep 01 TA - Canadian Journal of Surgery PG - E580--E592 VI - 65 IP - 5 4099 - http://canjsurg.ca/content/65/5/E580.short 4100 - http://canjsurg.ca/content/65/5/E580.full SO - CAN J SURG2022 Sep 01; 65 AB - Penetrating cardiac injuries require rapid diagnosis, efficient exposure and nuanced technical approaches, within a framework of highly coordinated and integrated multidisciplinary care. Acute care surgeons, with both strategic and technical expertise, are ideally positioned to address the potentially devastating consequences of these injuries. The aim of this narrative review is to offer a technical approach to the rapid evaluation, exposure, operative repair and postoperative care of penetrating cardiac injuries. A comprehensive review of the cardiac trauma literature, dating back to 1970, has provided a detailed toolbox of approaches to subxiphoid pericardial windows, resuscitative thoracotomy, median sternotomy, pericardiotomy, aortic clamping, cardiac hemorrhage control, cardiac repair, coronary artery injuries, pericardial closure, drain placement, chest wall closures, damage control thoracic procedures and immediate postoperative cardiac care, all based on fundamental physiological principles and anatomical considerations.