Jerusalem doctors save IDF combat soldier by leaving shrapnel in heart

A young soldier who was close to death after a six-millimeter piece of metallic shrapnel entered his heart during the fighting in Gaza has been saved “miraculously” when Shaare Zedek Medical Center (SZMC) cardiothoracic surgeons decided after consultation here and abroad to treat the bleeding but to leave the projectile in his heart. 

Dr. Danny Fink, head of the Jerusalem hospital’s cardiothoracic surgery department, told The Jerusalem Post that the team also conducted an Internet search to determine if such a rare case had occurred before and found that there have been only a few in the world in which shrapnel was safely left in the heart. “It was a case of risk versus a chance to save his life,” he said. 

Amit Bar-Ze’ev, a combat soldier from the north who is in his 20s, was rushed from the battlefield to SZMC about a week after the IDF moved into Gaza. The IDF decided to fly him by helicopter for treatment at the Jerusalem medical center because of the hospital’s significant experience in treating wounds to the heart. 

“We decided in real time. He was in immediate danger,” Fink related. 

“We did this in real time, he was in immediate danger. Fortunately, after cardiac rehabilitation at Sheba Medical Center, he is now home and feeling well. He will return here soon for a follow up examination.” Asked if Bar-Ze’ev could return to military service, Fink said there was no physical reason he couldn’t, but that he and the IDF would have to decide. 

“Fortunately, the shrapnel entered the right side of his heart; if it had been on the left side, it could have penetrated his brain and killed him,” Fink said. “I’ve treated a lot of trauma wounds to the heart, but I don’t remember such a case in three decades of my career.”

IDF soldier underwent life-saving operation 

The director of the trauma unit, Dr. Alon Schwartz, and his team immediately noticed from examining him and ultrasound imaging that this was a serious case of heart damage. The combat soldier underwent a life-saving emergency operation to stop the bleeding and release the pressure of the blood in the sac holding the heart that had been caused by the entrance of the shrapnel.  

“During the imaging, we clearly saw that a metal shard that penetrated the heart and had settled in the right cavity of the heart, penetrating deep into the organ. The hole in the shell around the heart was closed, with the surgeons facing the difficult dilemma of what to do further. With the shrapnel lodged in the right side of the heart, there was a risk that if it moved into the circulatory system, it would reach the lungs and have to be removed from there, but that is not an immediate threat to life.” After monitoring the piece of metal, they saw that it had not moved from its position. 

The team of doctors led by Fink, Schwartz, Dr. Danny Fink, interventional cardiologist Dr. Amir Orlev, and an IDF doctor decided to leave the shard in the heart and allow it to produce internal tissue around it to fix it in place instead of pulling the fragment out. Dr. Phillip Levin, director of intensive care, supervised his recovery.