Primary operative management: method of choice for stab wounds to the heart

Experiences in managing patients suffering cardiac stab wounds and coming to the University of Alabama Hospital in Birmingham from January 1964 to July 1972 are reviewed. From 1964 through July 1971, conservative management was used primarily, but most patients ultimately required operation. Analysis of our experiences during this period convinced us of the advisability of primary operative management for these patients, and since July 1971, primary operative management has been used. In the years from January 1964 to July 1972, 34 patients with cardiac stab wounds were treated at our hospital. Ten were managed conservatively with three deaths among this group. The remaining 24 received operative management either primarily or secondarily, and all of these patients survived. A patient managment program is outlined.