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A Stab In The Forbidden Territory
Khuzaima Tariq1, Asmat Achakzai1, Muneer Amanullah1
1National Institute of Cardiovascular Diseases, Liaquat National Hospital, Karachi, Pakistan.
Insights
A rare case of complete left anterior descending artery transection and right ventricular tear from penetrating chest trauma was successfully treated. This highlights the critical role of prompt surgical intervention and team coordination in managing complex cardiac injuries.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Emergency Medicine
Background:
- Penetrating heart injuries carry high mortality.
- Coronary artery lesions from trauma are exceptionally rare and often fatal.
Observation:
- A patient presented with a massive chest wound from a knife stab, exhibiting complete transection of the left anterior descending (LAD) artery and a right ventricular (RV) tear.
- The complex cardiac trauma involved both a major coronary artery and a cardiac chamber.
Findings:
- Successful surgical management of complete LAD artery transection and RV perforation was achieved.
- The patient survived a catastrophic cardiac injury due to timely and decisive surgical intervention.
Implications:
- This case underscores the critical role of prompt surgical intervention in complex cardiac trauma.
- Emphasizes the importance of coordinated team dynamics and regular emergency drills for surgical staff.
Abstract:
Penetrating heart injuries are associated with higher mortality rates. Coronary lesions caused by penetrating trauma are considered even rarer and universally fatal. We present a case of a fortunate survivor who had complete transection of left anterior descending (LAD) artery with right ventricular (RV) tear after being stabbed by knife, arriving in emergency unit with massively bleeding chest wound. Complex cardiac trauma involving coronaries and cardiac chambers is a challenge to surgeons if patients miraculously reach the hospital alive. This patient had complete transection of LAD artery with penetration into RV cavity, he was successfully managed by timely and prompt surgical intervention by on call team. This case highlights the importance of team dynamics working in harmony during emergency situations, we stress upon conducting routine drills to train surgical residents, perfusionists and operation theatre staff.
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