>Year 2000, Issue 4
Asensio JA, Ceballos JJ, Forno W, Gambaro E, Chahwan S, Marengo J, Hanpeter D, Demetriades D
Penetrating cardiac lesions. A review from their historical origins to the last frontiers of the new millennium (Part II)
Cir Gen 2000; 22 (4)
PDF: 4. Kb.
Objective: To describe the aspects involved in the management of cardiac lesions, from its historical antecedents to the latest trends in surgical treatments and their influence on current state of art.
Design: Review and selection of the corresponding bibliography (17 references).
Setting: Third level health care university hospital.
Results: Since the first successful repair of a cardiac lesion en 1896 by Rehn, in Germany, a hallmark in cardiac surgery, this discipline has evolved until the present day protocols designed for the management of these lesions, based on the experience of different authors, which have allowed a high survival rate of cardiac patients. Beall et al. 1961, were the first to propose a thoracotomy and direct cardiac massage in patients experiencing a cardiac arrest, this is currently a procedure widely recommended by the American College of Surgeons and universally accepted. The present review describes this technique and other surgical techniques, starting with the cutaneous incision to the accessory maneuvers or the use of biological and autogenic prostheses. We review and comment the corresponding literature and provide information based on our ample experience in the management of these lesions, including three new prospective studies described in the literature. This concludes a series of two articles, in remembrance of those pioneering surgeons, pretending to enlighten our younger surgeon on the bases of present day cardiac surgery. They might perhaps in the future cite our work as the trauma surgeons of the last millennium when reviewing the literature before publishing their new advances in this field.
||History of Medicine, cardiac surgery.
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Beall AC Jr, Diethrich EB, Crawford HW, Cooley DA, De Bakey ME. Surgical management of penetrating cardiac injuries. Am J Surg 1966; 112: 686-92.
Boyd TF, Strieder JW. Immediate surgery for traumatic heart disease. J Thorac Cardiovasc Surg 1965; 50: 305-15.
Sugg WL, Rea WJ, Ecker RR, Webb WR, Rose EF, Shaw RA. Penetrating wounds of the heart. An analysis of 459 cases. J Thorac Cardiovasc Surg 1968; 56: 531-45.
Beall AC Jr, Gasior RM, Bricker DL. Gunshot wounds of the heart. Changing patterns of surgical management. Ann Thorac Surg 1971; 11: 523-31.
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Durham LA, Richardson RJ, Wall MJ Jr, Pepe PE, Mattox KL. Emergency center thoracotomy: impact of prehospital resuscitation. J Trauma 1992; 32: 775-9.
Millham FH, Grindlinger GA. Survival determinants in patients undergoing emergency room thoracotomy for penetrating chest injury. J Trauma 1993; 34: 332-6.
Coimbra R, Pinto MC, Razuk A, Aguiar JR, Rasslan S. Penetrating cardiac wounds: predictive value of trauma indices and the necessity of terminology of standarization. Am Surg 1995; 61: 448-52.
Asensio JA, Murray J, Demetriades D, Berne J, Cornwell E, Velmahos G, et al. Penetrating cardiac injuries: a prospective study of variables predicting outcomes. J Am Coll Surg 1998; 186: 24-34.
Asensio JA, Berne JD, Demetriades D, Chan L, Murray J, Falabella A, et al. One hundred five penetrating cardiac injuries: a 2-year prospective evaluation. J Trauma 1998; 44: 1073-82.
>Year 2000, Issue 4