Conservative Management of Retained Cardiac Missiles: Case Report and Literature Review

Lundy, Jonathan B.; Johnson, Eric K.; Seery, Jason M.; Pham, Tach; Frizzi, James D.; Chasen, Arthur B.

doi:10.1016/j.jsurg.2009.04.002

Cited by 49 publications

(62 citation statements)

References 73 publications

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“…Limited data exist regarding the conservative management of intracardiac material after trauma [3,4]. In our case the medical staff decided to evacuate the compressive pericardial effusion, but not to remove the myocardial lead shots.…”

Section: Treatment Of Intracardiac Foreign Bodies In Emergency Conditmentioning

confidence: 86%

A Hunting Accident

Niamkey¹,

Ricci²,

Messner³

et al. 2016

ICFJ

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A 65-year-old male was admitted to the emergency department after sustaining a gunshot wound to his chest and abdomen, owing to a hunting accident. He was initially haemodynamically stable with a blood pressure of 120/70, and his ECG showed no particular disturbance. Computed tomography revealed multiple buckshot in his thorax and his abdomen (Figure 1). In the heart, two lead shots were situated in the interventricular septum, accompanied with a slight hemopericardium.

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Section: Treatment Of Intracardiac Foreign Bodies In Emergency Conditmentioning

confidence: 86%

A Hunting Accident

Niamkey¹,

Ricci²,

Messner³

et al. 2016

ICFJ

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“…In this regard, a conservative management of a retained intracardiac missile has been relatively recently reported for a patient who had a 2 cm × 2 mm intracardiac missile following a mortar blast. 6 Another large review involving 285 patients with battle cardiac injuries, identified factors affecting survival. Young age, early transportation to a specialized center, hospital setup, type of missile, early intervention, hemodynamic stability at presentation and type of the cardiac lesion, are good prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Survival after penetrating Shrapnel to the Heart and Colon: Which Injuries to tackle First?

Rabie¹,

Gallo²,

Refaie³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Aim: To report on the clinical course of a patient who received penetrating shrapnel to the heart and colon.Background: Penetrating missiles to the heart is a highly lethal incident, particularly, when associated with other serious injuries.Case report: This is the case of a 29-year-old male soldier, who sustained multiple shrapnel injuries caused by an explosive device in the war zone. Shrapnel penetrated the cecum and another lodged in the interventricular septum of the heart. Surprisingly, the patient was stable enough to undergo a staged procedure, where he was subjected to limited right hemicolectomy first, followed by open heart surgery to extract the cardiac shrapnel twelve hours later. His convalescence was uneventful and was discharged in a good condition. Conclusion:With timely intervention and close collaboration between the concerned clinicians in specialized centers, patients with penetrating shrapnel to vital structures, including the heart, could have a successful outcome.Clinical significance: Critical thinking is needed to prioritize which injuries to deal with first, in patients with near lethal injuries.

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“…Patients have been managed conservatively with favorable outcomes [8,9]. However, the decision to either percutaneously or surgically retrieve the foreign body should be based on patient's symptoms and assessment of the future risk of complications [9,10]. The mitral valve apparatus was totally destroyed from the mechanical trauma by the sharp edge of the needle.…”

Section: Discussionmentioning

confidence: 99%