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The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 450-457, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
I Asfaw, NW Thoms and A Arbulu
In the past 7 years, 1967 through 1973, 12 patients who had
interventricular septal defects from penetrating stab wounds of the thorax
were treated at Detroit General Hospital. In 10, the defects were confirmed
by cardiac catheterization. Four of the 12 patients were symptomatic and
required surgery. Two of these patients had pulmonary- to-system flow
ratios less than 2:1. Both these patients had left ventricular dysfunction
as a result of coronary artery and myocardial damage from the penetrating
trauma to the left ventricle. One of the 4 patients had an injury to the
tricuspid valve; this is the first reported case of a traumatic
interventricular septal defect associated with a left ventricle-right
atrium shunt and tricuspid valve insufficiency. Another patient had a
laceration of the left anterior descending coronary artery, in addition to
the interventricular septal defect. Ligation of the injured artery resulted
in a left ventricular aneurysm. Three patients had "multiple defects" in
the muscular septum which proved to be a single interventricular septal
defect in which the left to right shunt was divided into multiple jets by
the trabeculae carneae of the right ventricle.
ARTICLES
Interventricular septal defects from penetrating injuries of the heart: a report of 12 cases and review of the literature
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