Penetrating wound of the right ventricle

Authors

Keywords:

cardiac suture, cardiac tamponade, penetrating cardiac injury, pericardiocentesis, thoracotomy

Abstract

Introduction: Penetrating cardiac injuries represent a severe form of trauma, characterized by an unfavorable prognosis and an extraordinarily high mortality rate. The severity of these injuries is due to the critical urgency with which they must be treated.

Objective: To describe the preoperative management and surgical treatment of a stab wound to the right ventricle with cardiac tamponade.

Clinical case: A 34-year-old male patient sustained a stab wound to the precordial region. He arrived at the emergency department with mucocutaneous pallor, jugular venous distension, tachycardia, hypotension (80/50 mmHg), and markedly diminished heart sounds. Echocardiography revealed cardiac tamponade, and pericardiocentesis was performed. An emergency left anterolateral thoracotomy was then performed, revealing a penetrating wound on the anterior surface of the right ventricle. This was repaired with two mattress sutures and an autologous pericardial patch. The patient had a favorable recovery and was discharged from the hospital on the fifth postoperative day.

Conclusions: The successful treatment of penetrating cardiac injuries depends on immediate coordination between the emergency, anesthesia, and surgical teams. Prompt preoperative management and effective surgical repair are crucial for a favorable prognosis.

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Author Biography

Osvaldo Valdés Dupeyron, Unicersidad Técnica De Manabi. Ecuador, Hospital Verdi Cevallos Balda

Cirujano Vardiovascular Hospital Verdi Cevallos Balda, Profesor de Cardiología de la Universidad Técnica De Manabí

References

1. Hromalik LR Jr, Wall MJ Jr, Mattox KL, Tsai PI. Penetrating cardiac injury: a narrative review [Internet]. Mediastinum. 2023; 7:15. DOI: 10.21037/med-22-18

2. Valdés-Dupeyrón O, Alvia-Del Castillo G, González-Roble J, Espinales-Casanova L, Rodríguez-Marcos L, Lois-Mendoza N. Penetrating cardiac trauma in a second-level hospital. Presentation of two case [Internet]. Cardiovascular and metabolic science. 2022 [acceso: 19/08/2025]; 33(3): 113-7. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S295438352022000300113&lng=es

3. Grande AM, Antonacci F, Aseni P. Penetrating cardiac stab wounds: A case report with management algorithm and review of the literature [Internet]. Emergency Care Journal. 2018; 4(2): 63-7. DOI: https://doi.org/10.4081/ecj.2018.7384

4. Latif RK, Clifford SP, Ghafghazi S, Phipps Z, Chen JJ, Sangroula D, et al. Echocardiography and Management for Cardiac Trauma [Internet]. J Cardiothorac Vasc Anesth. 2022; 36(8 Pt B):3265-77. DOI: 10.1053/j.jvca.2022.02.010

5. Lateef Wani M, Ahangar AG, Wani SN, Irshad I, Ul-Hassan N. Penetrating cardiac injury: a review[Internet]. Trauma Mon. 2012; 17(1):230-2. DOI: 10.5812/traumamon.3461

6. Rehn L. Ueber penetrierende Herzwunden und Herznaht. Archiv für klinische Chirurgie. [Internet]. 1897 [20/12/2025]; 55:315-29. Disponible en: https://archive.org/details/b22327617

7. Embrey R. Cardiac trauma [Internet]. Thorac Surg Clin. 2007; 17(1):87-93. DOI: 10.1016/j.thorsurg.2007.02.002

8. Liu S, Ling L, Fu Y, Zhang WC, Zhang YH, Li Q, et al. Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center [Internet]. Chin J Traumatol. 2025; 28(4):288-93. DOI: 10.1016/j.cjtee.2024.07.009

9. Majeed ZS, Othman YN, Ali RK. Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report [Internet]. J Trauma Inj. 2023; 36(3):253-7. DOI: 10.20408/jti.2022.0073

10. Wall MJ Jr, Mattox KL, Chen CD, Baldwin JC. Acute management of complex cardiac injuries [Internet]. J Trauma. 1997; 42(5):905-12. DOI: 10.1097/00005373-199705000-00022

11. Ball CG, Lee A, Kaminsky M, Hameed SM. Technical considerations in the management of penetrating cardiac injury [Internet]. Can J Surg. 2022; 65(5):E580-E592. DOI: 10.1503/cjs.008521

12. Jimenez E, Martin M, Krukenkamp I, Barrett J. Subxiphoid pericardiotomy versus echocardiography: a prospective evaluation of the diagnosis of occult penetrating cardiac injury [Internet]. Surgery. 1990 [acceso: 20/12/2025]; 108(4):676-9. Disponible en: https://europepmc.org/article/med/2218879

13. Valdés-Dupeyrón O, Alvia-del Castillo GK, Espinales-Casanova L, Gonzáles-Robles J, Rodríguez-Marcos L, Lois-Mendoza N. Trap-door thoracotomy as an ideal access route for internal cardiac massage and repair of subclavian vessels [Internet]. Cardiovascular and metabolic science. 2023 [acceso: 19/08/2025]; 34(2): 59-65. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2954-38352023000200059&lng=es

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Published

2026-02-05

How to Cite

1.
Valdés Dupeyron O, Alvia Del Castillo GK, Paz y Miño Intriago WZ, Villavicencio Cedeño OA, Rodríguez Marcos L, Espinales - Casanova L, et al. Penetrating wound of the right ventricle. Rev. cuba. med. mil [Internet]. 2026 Feb. 5 [cited 2026 Feb. 6];55(1):e026076963. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/76963

Issue

Vol. 55 No. 1 (2026): January - March (In progress)

Section

Case Presentation

License

Copyright (c) 2026 Osvaldo Valdés Dupeyron, Gino Kleiver Alvia Del Castillo, Walter Zhukov Paz y Miño Intriago, Orlando Andrés Villavicencio Cedeño, Lisette Rodríguez Marcos, Lidia Espinales - Casanova, José Freddy Macías Riera

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