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Updated: Aug 18, 2025

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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[Bullet fragment in the interventricular septum : Is surgery always obligatory ?]

Kaoutar Benjaout1, Saloua El Azzouzi1, Abdessamad Ait Brik2

  • 1Cardiac Surgery Department, University Hospital of Tangier, 90060, Tangier, Morocco.

Annales De Cardiologie Et D'Angeiologie
|December 6, 2022
PubMed

Insights

This case study highlights the conservative management of indirect cardiac gunshot wounds in stable patients. Careful follow-up is crucial for patients with bullet fragments in the interventricular septum.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Ballistics Medicine

Background:

  • Cardiac gunshot injuries present significant surgical challenges with no established management consensus.
  • Prompt surgical intervention is typically indicated for hemodynamically unstable patients with penetrating cardiac trauma.

Observation:

  • A 59-year-old male sustained an indirect cardiac gunshot injury.
  • The patient remained hemodynamically stable, allowing for detailed investigation.
  • Imaging revealed a bullet fragment lodged within the interventricular septum without additional cardiac complications.

Findings:

  • Conservative management was chosen for the stable patient with an isolated interventricular septum bullet fragment.
  • Regular, careful follow-up was implemented as the primary management strategy.

Implications:

  • Hemodynamically stable patients with cardiac gunshot injuries may benefit from conservative management guided by thorough investigation.
  • This case underscores the importance of individualized treatment strategies in managing complex cardiac trauma.
Abstract

Keywords:
Bullets fragmentsCT-scanCardiac injuryCase reportEchocardiographyGunshotPlaie cardiaquearme à feufragments de ballescanneréchocardiographie

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