THORACOSCOPIC PERICARDIAL WINDOW AND PENETRATING CARDIAC TRAUMA

Between September of 1991 and February of 1996, 108 patients with pene trating wounds near the heart, and with no obvious signs of cardiac in jury, underwent the creation of a diagnostic thoracoscopic pericardial window to rule out cardiac injury. In 33 patients (30.6%), the proced ure identified hemopericardium. Sensitivity for the procedure was 100% , specificity 96%, and accuracy 97%. There were no deaths and no compl ications due to the procedure, The thoracoscopic pericardial window ha s proved to be a precise, rapid, and safe method for the diagnosis of heart wounds in patients with no clear signs or symptoms, and it also allows the evaluation of other thoracic injuries and the evacuation of hemothorax when present, We recommend this procedure as the standard diagnostic approach for cardiac injuries in patients in stable conditi on.