Background: Penetrating wound of the heart should be suspected in any patient with penetrating wound of the chest, upper abdomen or neck and particularly of the anterior aspect of the left chest wall in proximity to the heart.
Case Report: In this paper, we present 3 cases of penetrating heart injury associated with pulmonary injury, which were successfully operated on. All patients were young males. Postoperatively, 2 patients requiring cardiopulmonary bypass (CPB) underwent revision operation due to bleeding. Early recognition of cardiac injury is the precondition of success. Hemodynamically unstable patients with penetrating cardiac wound should be taken to the operating room immediately without performing time-consuming procedures. Because of their small size and protected location, selective penetrating injuries to the coronary arteries are uncommon.
Conclusions: The present cases of severe left ventricular injury associated with pulmonary injury, which might have had a disastrous outcome if delayed, underline the value of emergent surgery in unstable penetrating thoracic injury. Additionally, coronary revascularization may provide a safe alternative therapy to primary ligation for management of proximal left anterior descending
artery (LAD) injuries.

Keywords: Penetrating Cardiac Injury