Stab wounds penetrating the left atrium.

A stab wound penetrating the left atrium (excluding the left auricle) would have to penetrate through other chambers of the heart or through the great arteries at their origin from the heart to reach the left atrium from the front of the chest. Such wounds would be fatal, the patient dying from profuse haemorrhage within a few minutes. A stab wound through the back of the chest could reach the left atrium in the narrow sulcus between the root of the left lung in front and the oesophagus and descending thoracic aorta behind, but placing a wound at this site without at the same time severing the vessels in the root of the left lung or the descending thoracic aorta would be an exceptional event, and the survival of a patient after a stab wound penetrating the left atrium would be dependent on it. The present case of survival after a stab wound penetrating the left atrium appears to be the only one of its kind in the literature. It is reported not only on account of the rarity of its occurrence but also because of the unusual methods used to arrest the haemorrhage. Our experience in this case stimulated us to investigate by experimental surgery on animals the possibility of arresting haemorrhage from stab wounds of the heart without sutures, and these experiments confirmed the feasibility of this being done, even with stab wounds penetrating the ventricles of the heart.