If the patient is hemodynamically unstable or with cardiac tamponade, like the patient who is stable, but hemopericardium is confirmed, the management is surgical with drainage of the pericardial sac followed by cardiorrhaphy
. Nevertheless, possibility of nonoperative management with pericardial drainage has been considered in patients with hemodynamic stability, with no signs of cardiac tamponade, and with hemopericardium and absence of active bleeding .
In his address to the German Society of Surgery, Rehn said 'the feasibility of cardiorrhaphy no longer remains in doubt ...
(55) The majority of surgeons were convinced at this time that the best form of therapy for severe haemorrhage from a cardiac wound was cardiorrhaphy, but doubt still remained about the management of cardiac tamponade.