Pretoria - A few millimetres of muscle – that was all that stood in the way of a fatal injury for a talented school rugby player after he was hit by a gun pellet.
Thanks to a multidisciplinary heart surgery team, however, Ian Venter’s life was saved, and he was back in class within a matter of weeks and training once again.
Ian, an active 15-year-old from Fochville, is just like any other sporty youngster who loves the outdoors, especially playing rugby.
But after a recent accident with a high velocity pellet gun, Ian suddenly found himself fighting for his life.
Dr Elias Zigiriades, a cardiothoracic surgeon practising at Netcare Krugersdorp Hospital, said the tiny bullet had gone through Ian’s breastbone, penetrating two chambers of his heart.
It missed his coronary artery by less than a centimetre before stopping just outside the right ventricle – the chamber responsible for pumping blood to the lungs for oxygenation.
“It was remarkably lucky that the pellet had entered Ian’s chest where it did, as the chances of saving his life could have been significantly reduced. As it was, his heart had already undergone considerable trauma. Because the pellet was so small and its location was not immediately easy to identify, we had to tread with caution,” Zigiriades said.
With the operating team on standby, he worked with a radiologist and cardiologist to conduct a CT angiogram – a non-invasive scan – which allowed them to create a 3D representation of Venter’s heart to locate the pellet, which had done a surprising amount of harm.
“We were astonished at just how deep an impact that little pellet had made. While we could see areas of damage that it had caused, it was difficult to ascertain whether it had stopped inside or outside the muscle wall.”
Zigiriades said Ian’s treatment had already been delayed by an unfortunate series of events, with the emergency services provider taking him to a different hospital before he was referred to the Netcare Krugersdorp Hospital.
Ian’s mother, Teresa Venter, recalled the dread she felt when she heard her son would have to undergo open-heart surgery.
“Accidents happen, especially with kids, but I never thought that my fit and healthy son would be going in for a procedure like this.”
Zigiriades said that once Venter was in theatre, two astonishing discoveries were made.
“Once I had begun to operate, we saw there was an enormous amount of blood surrounding Ian’s heart – about 800ml to 1 litre – that needed to be drained. Most patients are already very unstable at around the 200ml mark, so the fact that Ian had even made it this far was remarkable,” he said.
Zigiriades said it was also at this time that they could see how close the pellet had come to Ian’s coronary artery.
“Ian would never have made it here if it had hit that artery. He must have had a few guardian angels watching over him,” he said.
Fortunately, Zigiriades and his team managed to uncover the full extent of the damage. Once the pellet was removed and the tears repaired, Ian was transferred to the hospital’s cardiothoracic intensive-care unit.
By the following morning, he was already sitting in a chair, and within six days, was ready to be discharged.
His mother said the timing meant Ian missed only a few days at the start of the school term, and aside from a brief hospital visit to have fluid drained from his lungs – a common occurrence after open-heart surgery – he was in excellent health.
Ian started exercising daily to rebuild his muscle strength and condition, and is already training for the next rugby season.