Obscure traumatic cardiac lesion after a penetrating chest injury: Review of the literature

We report a young man who sustained a penetrating chest injury after an assault. He was immediately transferred from a regional hospital to Queen Mary Hospital for definitive treatment after initial stabilization. Emergent thoracotomy was done in the operating theatre and primary repair of a cardiac laceration was performed. Postoperative transoesophageal echocardiography showed a large residual ventricular septal laceration with significant left to right intracardiac shunting. He had an open repair in a cardiac surgery centre the next day. A 1.5 cm laceration was found at the ventricular septum and repair was performed. Postoperative transoesophageal echocardiography showed no further ventricular septal defect. He underwent uneventful recovery and was discharged on day 6 postoperation. Follow up at 1 month postoperation did not show any abnormalities and he subsequently defaulted further follow up.