[Treatment of cardiac stab wounds. A thirty-one-year experience]

Penetrating cardiac wounds represent a dramatically pathology of the general surgery because of their clinical presentation and outcome. The cardiorrhaphy with the three successive times, carried out with maximum rapidity is the only safe and efficient surgical technique which leads to hemostasis and healing. The aim of this study was to evaluate our results and experience of penetrating cardiac injuries treated at the Clinic of Surgical Emergencies from Iaşi. 20 patients, 17 men and 3 women, of mean age 34 years (range 18-51), with stab wounds, underwent cardiorrhaphy between 1974 and 2004. The clinical aspects were: "white injured" (hemorrhagic shock) in 3 patients, "blue injured" (cardiac tamponade) in 8 patients, both being implied with some patients, one of the aspects being predominant. 9 patients (45%) had only cardiac injuries and 11 (55%) had other associated injuries. There were 7 intraoperative cardiac arrests and 2 postoperative pulmonary complications. In 16 cases the outcome of patients with cardiac stab wounds was favourable. We recorded 4 deaths. Mortality results from the wounds of the right auricle. The high rate of survival (80%) proves that a penetrating cardiac injury with a heavy prognosis may be turned into a relative traumatism harmless for those patients who will remain alive until they arrive in hospital.