RT Journal Article
SR Electronic
T1 Technical considerations in the management of penetrating cardiac injury
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP E580
OP E592
DO 10.1503/cjs.008521
VO 65
IS 5
A1 Chad G. Ball
A1 Alex Lee
A1 Matthew Kaminsky
A1 S. Morad Hameed
YR 2022
UL http://canjsurg.ca/content/65/5/E580.abstract
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.