[Clinical aspects of cardiac stab wounds: report of 20 cases]

Penetrating cardiac wounds are the most dramatic injuries which need a rapid diagnosis and surgical intervention. This clinical pathology has a high increasing incidence in the whole world. We aimed to present our personal experience in such cases. The study was carried out along a period of 31 years. From 1974 to 2004, 20 patients (mean age, 34 years; 17 male) with penetrating cardiac stab wounds were treated. The initial clinical presentation was cardiac tamponade ("blue injured"-8 patients, 40%), hemorrhagic shock ("white injured"-3 patients, 15%), both being implied with 8 patients (40%), one of the aspects being predominant. One patient was stabile. All patients were immediately transferred to the operating room. The left ventricle was found to be the most frequent site of injury (7 patients, 35%), followed by right atrium (6 patients, 30%), right ventricle (4 patients, 20%), left atrium (1 patient, 5%) and both ventricles (1 patient, 5%). There were 17 (85%) penetrating cardiac wounds, 2(10%) penetrant stab injuries and one (5%) non-penetrant cardiac wound. Cardiorrhaphy was performed in all cases. The postoperative complication was pneumonia in 2 cases. In the present study, the survival rate was significantly high (80%). In conclusion, these promising results suggest that a wound with a severe prognosis may be turned into a relative trauma, harmless for the patients who will survive until surgical admission.