ELECTIVE CORRECTION OF INTRA-CARDIAC LESIONS RESULTING FROM PENETRATING WOUNDS OF THE HEART
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Date
1979
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Abstract
Controversy exists regarding the timing and technique of total correction of traumatic intracardiac lesions. Patients (5) with penetrating wounds of the heart received emergency treatment aimed at securing normal hemodynamics. No attempt was made to identify intracardiac lesions at this stage. Cineangiography 2 mo.-7 yr later showed aorto-right ventricular fistulae in all patients, associated in 2 with aortic cusp laceration and in 1 with an aorto-left atrial fistula. The surgical approach for aorto-right ventricular fistula was through the right ventricle or aorta. Valvar injuries were treated by plastic reconstruction. All patients showed good clinical results when seen 4-11 yr later. Traumatic intracardiac lesions in patients with stable hemodynamics after initial treatment should be operated on electively. The aortic approach is preferable for aorto-right ventricular fistulae. Conservative plastic repair of valvar injuries achieves long-term competence thus avoiding prosthetic replacement.