Right ventricular thrombus after penetrating cardiac injury

Methods A 37 year old man had been stabbed with a knife to the epigastric area. Twenty minutes after the incident he was admitted to the University Hospital Centre Split. After aggressive resuscitation the patient was transferred to emergency operating theatre without any prior diagnostic procedures. Abdominal cavity was explored by laparotomy, and no evident damage to the abdominal organs was found. Because of hemodynamic instability and high suspicion of cardiac tamponade a left thoracotomy was performed and the stab wound measuring 40mm in length to the right ventricle was located 20mm away from middle third of the left anterior descending artery. Because of space restrictions it was decided to do a middle sternotomy. The entry wound was explored and sutured with two pledgeted 4.0 polypropylene sutures, without the support of the heart-lung machine.