Subxiphoid pericardial window in the diagnosis of penetrating cardiac trauma.

During a 15-month period, a subxiphoid pericardial window was performed as a diagnostic method to rule out cardiac injury in 76 patients with penetrating wounds near the heart. Patients with an obvious diagnosis of cardiac tamponade or patients in severe shock were excluded. Seventy-four patients were male, and 2 were female. The average age was 26.7 years. The procedure was done under general anesthesia in every case. There were no false-positive or false-negative results. There were no deaths, and the morbidity rate was 1.3%. In 16 patients (21%), the procedure identified hemopericardium. In our hands, the subxiphoid pericardial window has proved to be a rapid, precise, and safe method for the diagnosis of wounds of the heart. Until a less invasive procedure proves more precise, we recommend it as the standard diagnostic approach for cardiac injuries in patients in stable condition.