RT Journal A1 Pate JW, Richardson RL, Jr. T1 PEnetrating wounds of cardiac valves JF JAMA JO JAMA YR 1969 FD January 13 VO 207 IS 2 SP 309 OP 311 DO 10.1001/jama.1969.03150150021004 UL http://dx.doi.org/10.1001/jama.1969.03150150021004 AB Penetrating injury to cardiac valves occurred in two patients. A patient with acute tricuspid insufficiency and conduction-bundle injury due to a gunshot wound had immediate valve replacement, pacemaker implantation, and excision of the lower lobe of the right lung with subsequent recovery. We believe this to be the first case of valve replacement for a gunshot wound successfully done at initial exploration. A patient had mitral insufficiency due to stab wound with eventual valve replacement. Early, definitive surgery with a heart-lung machine available is urged for all gunshot wounds and stab wounds suspected of causing major intracardiac damage.