Cardiac Injuries: Experience with Six Cases at Fann National University Hospital

Cardiac injuries correspond to a disruption of the continuity of the cardiac layers caused by a penetrating mechanism, with or without loss of tissue; they are considered penetrating when they extend beyond the parietal pericardium. These lesions most frequently occur following penetrating chest trauma but may also complicate blunt trauma through myocardial contusion, occasionally leading to tears, ruptures of the cardiac walls, or valvular damage. Penetrating cardiac trauma represents one of the most severe forms of thoracic injury, with high mortality despite specialized management. We report a retrospective, descriptive, and analytical study conducted over a ten-year period (2014–2024) in the Thoracic and Cardiovascular Surgery Department of Fann University Hospital in Senegal, including all patients operated on for cardiac or great vessel injuries. Six cases were identified, with a male predominance (sex ratio 5:1) and a mean age of 22 years. Most injuries resulted from interpersonal violence and assaults. Four patients presented with hemodynamic instability on admission, including two with cardiac tamponade. Transthoracic echocardiography was performed in five patients, chest radiography and CT scanning were used in two cases. All patients underwent median sternotomy. The right ventricle was the most frequently affected structure (66%), requiring cardiomyorraphy. Postoperative outcomes were uneventful in four patients, whereas one case of seizures and one septic shock were reported. Overall mortality was 33.3%. Cardiac injuries remain rare but severe events, predominantly affecting young individuals; their diagnosis relies primarily on clinical evaluation supported by echocardiography, and their management is surgical, usually without extracorporeal circulation, with a prognosis still marked by significant mortality. Our objective is to describe the experience in the surgical management of six cases of cardiac injuries treated at Fann National University Hospital over a ten-year period.