Surgical Treatment of Multiple Nail Gun Chest Wounds

We present a case of a 48-year-old patient with multiple penetrating stab wounds of the heart after a suicide attempt with a nail gun. The patient was admitted in stable condition. A chest radiograph (Figure 1A) and computed tomography scan (Figures 1B, 1C [Ao, aorta; LA, left atrium]) revealed 21 nails penetrating the heart and major vascular structures. The patient underwent emergent cardiac operation with cardiopulmonary bypass support initiated before chest opening. The nails from the heart were carefully removed, including the surrounding thrombus (Figure 1D). The postoperative course was complicated by a mild ischemic stroke. The patient was discharged from the hospital without any neurologic deficits. Surgical management of stab wounds of the heart is a lifesaving procedure that can be performed safely with cardiopulmonary bypass support,1Fang X. Yu C. He F. The self-inflicted multiple organs injury with nail gun.Heart Surg Forum. 2021; 24: E1049-E1051Crossref PubMed Scopus (1) Google Scholar which promotes safety and potentially reduces the risk of a significant stroke. However, the number of penetrating nails in our case draws attention to periprocedural stroke as an important complication of foreign material extraction from the heart and great vessels. The authors have no funding sources to disclose.