ABSTRACT
Nail-gun injury to the heart is rare. Nail-gun injury to the interventricular septum is rarer: we could find only 5 reported cases, and none involving a child. We report 2 additional cases, in which nails penetrated the interventricular septum without causing acute pericardial tamponade, heart block, or shunt across the septum. Transesophageal echocardiography provides a dynamic way to evaluate the patient preoperatively, intraoperatively, and postoperatively. In the cases reported here, both the adult with multiple interventricular nails and the child with a single nail underwent foreign-object removal via median sternotomy. The child needed cardiopulmonary bypass for removal of the nail. There were no short-term or long-term sequelae from these interventricular septal injuries.
Subject(s)
Foreign Bodies/etiology , Heart Injuries/etiology , Ventricular Septum/injuries , Wounds, Penetrating/etiology , Accidents , Adult , Cardiopulmonary Bypass , Child, Preschool , Echocardiography, Transesophageal , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Heart Injuries/diagnosis , Heart Injuries/surgery , Humans , Male , Sternotomy , Suicide, Attempted , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, Interventional/methods , Ventricular Septum/diagnostic imaging , Ventricular Septum/surgery , Wounds, Penetrating/diagnosis , Wounds, Penetrating/surgeryABSTRACT
Patients with obstructed total anomalous pulmonary venous connection (TAPVC) usually present critically ill and continue to be extremely challenging with presurgical stabilization. We present an extra corporeal membrane oxygenation (ECMO)-dependent neonate with obstructed TAPVC that was successfully palliated with transvenous stent placement in the obstructed vertical vein.
