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Management of Penetrating Wounds of the Heart

Richard J. Cleveland, MD; John R. Benfield, MD; Gary M. Nemhauser, MD; Richard R. Lower, MD
Arch Surg. 1968;97(3):517-520. doi:10.1001/archsurg.1968.01340030177020.
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WHETHER penetrating wounds of the heart should be treated with pericardicentesis or operative repair remains moderately controversial.1-4 However, the fact that selected cases of penetrating heart wounds demand operation is no longer disputed, and it is becoming increasingly apparent that certain patients will require the use of cardiopulmonary bypass for operative repair of traumatic intracardiac injuries.5-7 The purpose of this report is to emphasize this concept, and to demonstrate the value of individual evaluation of each case. Our experience supports the concept that strict adherence to the use of either pericardicentesis or operation is no longer realistic, and that the complexity of heart injuries may vary from very simple ones to those requiring delayed diagnosis by cardiac catherization and subsequent elective open-heart repair.

The 12 patients who comprise this study ranged in age from 12 to 41 years. Four were managed by pericardicentesis alone while the remainder underwent

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