Sutureless Repair of a Full-Thickness Cardiac Stab Wound Adjacent to the Right Coronary Artery Using Evarrest® Patch

In the past, deep mattress sutures, pledgeted repair, or in some cases, ligation with subsequent cardiac bypass of the affected vessel has been used.1 With the advent of new topical hemostatic agents, such as Evarrest® (Ethicon, Inc., Somerville, NJ), a topical flexible fibrin sealant patch, the possibility exists to forgo a more conventional suture repair. Because a conventional suture repair of the stab wound could potentially cause ischemic injury to the RCA or the subsequent branch, the decision was made to place an Evarrest® patch over the wound instead (Fig. 1 B). Christopher A. Butts, Ph.D., D.O. Division of Acute Care Surgery Department of Surgery Rutgers Robert Wood Johnson Medical School New Brunswick, New Jersey Ashleigh Hagaman, M.D. John Porter, M.D. Department of Trauma, Surgical Critical Care, & Acute Care Surgery Cooper University Hospital Camden, New Jersey Joshua P. Hazelton, D.O. Division of Trauma, Acute Care, and Critical Care Surgery Department of Surgery Penn State University College of Medicine Hershey, Pennsylvania Author contributions: