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Article
July 1946

REMOVAL OF SHELL FRAGMENT FROM LEFT VENTRICLE OF THE HEARTReport of a Case

Author Affiliations

MEDICAL CORPS, ARMY OF THE UNITED STATES

Arch Surg. 1946;53(1):13-23. doi:10.1001/archsurg.1946.01230060015002
Abstract

THE presence of a foreign body in the myocardium creates a dramatic and challenging situation. If the immediate needs of operation, such as cardiac tamponade, pericarditis or clotted hemothorax, are not present to clearly define surgical intervention, the question of surgical treatment is likely to harass the decison of the surgeon. Intracardiac foreign bodies have not been sufficiently frequent to establish a clear set of rules. As a result, the proverbial two schools of thought have not as yet merged. However, to date, opinion seems to favor removal or attempt at removal. Beck1 urged the extraction of foreign bodies from the pericardial cavity or myocardium as early as possible and stated that the lapse of time does not mitigate against surgical intervention, even though clinically the patient shows improvement. (The improvement will invariably also be reflected in serial electrocardiograms.) While it is true that a foreign body in the

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