Colin D Brown, MD, MS1, Jonathan Nguyen2. 1Dwight D. Eisenhower Army Medical Center, 2Grady Memorial Hospital
Background: Penetrating cardiac injury has increased in frequency in recent years and is well defined both in its repair and prognosis. However, there is little data to guide the treatment and prognosis of a large partial thickness injury to the myocardium.
Case: We present a case of a thoracic gunshot wound resulting in a 4×3 cm partial thickness injury of the left ventricle controlled by hemostatic agents and mesh repair of the pericardium (figure). The patient survived and was discharged with a depressed ejection fraction but was lost to follow up.
Discussion: Preoperative imaging directed our operative plan. Closing the wound was not an option due to the reduction in ventricle size and subsequent reduction of stroke volume. Therefore, other operative strategies needed to be applied. Penetrating cardiac injuries that survive to discharge have an excellent prognosis; however, the prognosis for a partial thickness injury is unknown.
Conclusion: This is an example of a unique injury pattern that has not been previously described. Management of this injury may result in uncertain long-term sequelae.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91992
Program Number: MSSP711
Presentation Session: Military Poster (Non CME)
Presentation Type: MSSPoster