Lucky in his misfortune: An arrow through the heart

Crossbow arrows were weapons used in the Middle Ages. Nowadays, they are essentially used for sport practice. Those weapons can induce major lesions either by accident or by suicide attempt. We report the case of a 48-year-old man who attempted to commit suicide with a crossbow. As he reached the hospital hemodynamically stable, with no tamponade on echocardiography, we performed a contrast-enhanced computed tomography scan. The arrow crossed the left internal thoracic artery, the pulmonary artery root, the left atrium, and ended in right transverse process. We performed a salvage cardiac surgery. The patient recovered uneventfully. We present and comment on our management of the patient.

Penetrating vascular and cardiac injuries can be faced by many physicians. Fortunately, these situations are scarce. There are main principles to manage these lesions, but every clinical case has its own particularities. We wish to help practicians who might face similar cases.