Cardiac Penetrating Trauma

In cardiac trauma there are two basic scenarios: 1. The patient is stable. In this case the best access is median sternotomy, because: It is less painful for the patient The exposure for the heart and the great vessels is optimal The disadvantage is that this approach provides limited access to other potentially injured structures, such as the lung, subclavian vessels, aorta, and intercostal vessels. 2. The patient is unstable. In this case the anterolateral thoracotomy offers several advantages: It is faster It can be made with basic instruments It allows access to several structures besides the heart