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>Journals >Cirujano General >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)

Language: Español
References: 117
Page: 380-388
PDF: 4. Kb.

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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.

Key words: History of Medicine, cardiac surgery.


  1. Macho JR, Markinson RE, Schecter WP. Cardiac stapling in the management of penetrating injuries of the heart: rapid control of hemorrhage and decreased risk of personal contamination. J Trauma 1993; 34: 711-6.

  2. Grabowski MW, Buckman RF Jr, Goldberg A, Badellino MM. Clamp control of the right ventricular angle to facilitate exposure and repair of cardiac wounds. Am J Surg 1995; 170: 399-400.

  3. Mattox KL, Limacher MC, Feliciano DV, Colosimo L, O’Meara ME, Beall AC Jr. Cardiac evaluation following heart injury. J Trauma 1985; 25: 758-65.

  4. Moore EE, Malangoni MA, Cogbill TH, Shackford SR, Champion HR, Jurkovich GJ, et al. Organ injury scaling IV: Thoracic, vascular, lung, cardiac, and diaphragm. J Trauma 1994; 36: 299-300.

  5. Trinkle JK. Penetrating heart wounds: difficulty in evaluating clinical series. Ann Thorac Surg 1984; 38: 181-2.

  6. Beall AC, Oschner JL, Morris GC. Penetrating wounds of the heart. J Trauma 1961; 1: 195-207.

  7. Beall AC, Morris GC, Cooley DA. Temporary cardiopulmonary bypass in the management of penetrating wounds of the heart. Surgery 1962; 52: 330-7.

  8. 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.

  9. Boyd TF, Strieder JW. Immediate surgery for traumatic heart disease. J Thorac Cardiovasc Surg 1965; 50: 305-15.

  10. 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.

  11. Beall AC Jr, Gasior RM, Bricker DL. Gunshot wounds of the heart. Changing patterns of surgical management. Ann Thorac Surg 1971; 11: 523-31.

  12. Steichen FM, Dargan EL, Efron G, Pearlman DM, Weil PH. A graded approach to the management of penetrating wounds of the heart. Arch Surg 1971; 103: 574-80.

  13. Mattox KL, Espada R, Beall AC. Performing thoracotomy in the emergency center. J Am Coll Emerg Phys 1974; 3: 13-17.

  14. Espada R, Whisennand HH, Mattox KL, Beall AC Jr. Surgical management of penetrating injuries to the coronary arteries. Surgery 1975; 78: 755-60.

  15. Ivatury RR, Shah PM, Ito K, Ramírez-Schon B, Suárez F, Rohman M. Emergency room thoracotomy for the resuscitation of patients with “fatal” penetrating injuries of the heart. Ann Thorac Surg 1981; 32: 377-85.

  16. Gervin AS, Fischer PP. The importance of prompt transport in salvage of patients with penetrating heart wounds. J Trauma 1982; 22: 443-8.

  17. Badai BI, Smith JP, Ward RE, O’Neill MB, Auburg R. Emergency thoracotomy in the management of trauma. JAMA 1983; 249: 1891-6.

  18. Rohman M, Ivatury RR, Steichen FM, Gaudino J, Nallathambi MN, Khan M, et al. Emergency room thoracotomy for penetrating cardiac injuries. J Trauma 1983; 23: 570-6.

  19. Mattox KL, Beall AC Jr, Jordan GL Jr, De Bakey ME. Cardiorrhaphy in the emergency center. J Thorac Cardiovasc Surg 1974; 68: 886-95.

  20. Ivatury RR, Nallathambi MN, Roberge RJ, Rohman M, Stahl W. Penetrating thoracic injuries: in-field stabilization vs prompt transport. J Trauma 1987; 27: 1066-73.

  21. Demetriades D, Charalambides C, Sareli P, Pantanowitz D. Late sequelae of penetrating cardiac injuries. Br J Surg 1990; 77: 813-4.

  22. Esposito TJ, Jurkovich GJ, Rice CL, Maier RV, Copass MK, Ashbaugh DG. Reappraisal of emergency room thoracotomy in a changing environment. J Trauma 1991; 31: 881-5; discussion 885-7.

  23. Lorenz PH, Steinmetz B, Lieberman J, Schecter WP, Macho JR. Emergency thoracotomy: survival correlates with physiologic status. J Trauma 1992; 32: 780-5; discussion 785-8.

  24. Durham LA, Richardson RJ, Wall MJ Jr, Pepe PE, Mattox KL. Emergency center thoracotomy: impact of prehospital resuscitation. J Trauma 1992; 32: 775-9.

  25. Millham FH, Grindlinger GA. Survival determinants in patients undergoing emergency room thoracotomy for penetrating chest injury. J Trauma 1993; 34: 332-6.

  26. 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.

  27. 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.

  28. 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.

>Journals >Cirujano General >Year 2000, Issue 4

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