Heart beating outside the chest
This is a rare case of ectopia cordis, a congenital malformation in which the heart is abnormally displaced either partially or totally outside of the thoracic cavity (extra-thoracic location) through a split sternum. Less often the heart may be situated in the abdominal cavity or neck (cervical). The exact etiology remains unknown, but abnormalities in the lateral body wall folds are believed to be involved. Normally, the lateral body walls are responsible for fusion at the midline to form the ventral wall. Corruption of this process may underlie ectopia cordis. This can be presented in association with other malformations such as the anterior abdominal wall resulting in omphalocele - the protrusion of the intestine outside the abdominal cavity.
Such cases are related to the other associated malformations, complex cardiac abnormalities, and difficulty returning the heart back into a small thoracic cavity, dooming to poor prognosis with few survivors even after a surgical repair. Many are getting into a cardiorespiratory arrest before any surgical intervention can be taken.
During surgery, the heart must be repositioned and the chest wall defect must be covered. Surgeons can create a temporary closure with synthetic material.