"mending A Broken Heart!" (a few technical tips on repairing penetrating trauma to the heart)

During the history operative repair of cardiac injuries was considered to be unmanageable and the first successful cardiomiorraphy was performed just around a century ago. Tamponade, more frequently than exsanguination are cause of death in penetrating cardiac trauma. This is a usualy lethal injury and those surviving to hospital have an overall mortality approaching 80%. The penetrating injury require some basic steps, not special operative dexterity. We present the technical management of this injury, certain danger points and pitfalls. Options for surgical exposure, technical details of suturing cardiac injuries, and exceptional conditions such as injury near the coronary artery are discussed in detail. Outcome data and future directions in managing this injury are also examined.