Blunt Traumatic Rupture of the Heart and Pericardium:

Fulda, Gerard J.; Brathwaite, C. M. E.; Rodriguez, A.; Turney, S. Z.; Dunham, C. Michael; Cowley, R. Adams

doi:10.1097/00005373-199102000-00003

Cited by 105 publications

(126 citation statements)

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“…Conversely, ventricular rupture is caused by direct compression of the anterior chest wall against the vertebral column during end diastole, when ventricular fi lling is maximal. 2 In an autopsy series in 1935, Bright and Beck 3 reported that incidence of rupture was almost equal for all four chambers. However, in a recent collective review, 75.5% of the survivors exhibited involvement of the right chambers.…”

Section: Location Of Tear and Survival Ratementioning

confidence: 98%

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Five cases of blunt traumatic cardiac rupture: success and failure in surgical management

Namai

Sakurai

Fujiwara

2007

Gen Thorac Cardiovasc Surg

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We report five cases of blunt cardiac rupture seen in our hospital during the last 6 years. All these patients sustained blunt chest trauma due to motor vehicle or motorcycle accidents, and all had vital signs on arrival at the emergency department. We suspected cardiovascular injuries from the findings of echocardiography and CT scans, and all five cases were operated on 2-6 h after injury. Four had a median sternotomy, and one had a lateral thoracotomy. During the operations, we found that two patients had pericardium injuries and all five patients had right chamber injuries, which included multiple, ventricle, and large venous injuries in three patients. The tears were repaired using simple suture or ligation techniques for all patients, with cardiopulmonary bypass in three patients. One patient died during the operation, and four patients survived, therefore the survival rate was 80%. We believe that patients with cardiac rupture who are alive when they reach hospital can often be saved by prompt diagnosis and immediate, adequate surgical repairs.

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Section: Location Of Tear and Survival Ratementioning

confidence: 98%

“…However, in a recent collective review, 75.5% of the survivors exhibited involvement of the right chambers. 4 Fulda et al 2 reported a study on a series of 59 patients who sustained blunt cardiac rupture. Twenty-nine of these patients arrived in the admitting area with vital signs, and the survival rate was 48%.…”

Section: Location Of Tear and Survival Ratementioning

confidence: 99%

Five cases of blunt traumatic cardiac rupture: success and failure in surgical management

Namai

Sakurai

Fujiwara

2007

Gen Thorac Cardiovasc Surg

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“…Of the 32 patients reported by Brathwaite et al [12], 21 (66%) had sustained their injuries in MVAs. Fulda et al [13] reported that 40 out of the 59 (68%) patients included in their study were involved in an MVA. Injury by fall is less common, 3% and 5%, respectively, in the studies mentioned above.…”

Section: Discussionmentioning

confidence: 97%

“…Yet large autopsy studies, like Parmley's classic paper, show that this injury is not rare [1]. In the literature, series indicate that blunt cardiac rupture is associated with a high mortality; for example, Brathwaite et al [12] reported 81% mortality in 32 cases in 1989, and Fulda et al [13] reported 76% mortality in 59 cases in 1991. Although all four heart chambers are equally susceptible to rupture or laceration [14], a better survival rate is associated with rightsided and atrial injuries [15].…”

Section: Discussionmentioning

confidence: 99%

Blunt Traumatic Rupture of the Left Atrial Appendage

et al. 2002

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Background: The diagnostic evaluation and surgical management of blunt cardiac rupture is one of the challenges of trauma surgery. Case Study: We report the case of an 18-year-old male with blunt traumatic left atrial appendage rupture who was brought to the hospital after a fall from the sixth floor of a building. On arrival at the emergency department, he developed signs of cardiac congestion. Ultrasonography of the heart through the subxiphoid window, as part of the focused assessment for the sonographic examination of the trauma patient (FAST), revealed cardiac tamponade. The injury was successfully repaired after median sternotomy. Discussion: Clinical symptoms, diagnostic considerations, and treatment modalities are commented on. The focus is on the role of FAST as a diagnostic tool in this case.

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“…The mortality rate has been reported to be much higher in the latter patients because of earlier fatal exsanguination due to the loss of the tamponading effece's Although rapid development of exsanguination or cardiac tamponade immediately after the initial injury or during transportation is the most likely the cause of the high mortality rate, 6 delays in diagnosis and treatment are also responsible for the high mortality. 3 Diagnosis of cardiac injury demands a very high index of suspicion, 3 and hypotension out of proportion to identifiable blood loss should prompt one to suspect cardiac tamponade as a part of the differential diagnosis. 6 From this standpoint, echocardiography is the most useful tool for diagnosing cardiac tamponade.…”

Section: Discussionmentioning

confidence: 99%

Pericardial drainage prior to operation contributes to surgical repair of traumatic cardiac injury

Sugimoto

Yamashita

Baba

et al. 1999

Jpn J Thorac Caridovasc Surg

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We report on two cases of successful surgical repair of cardiac injury: one involving a left ventricular stab injury and the other a blunt rupture of the right atrium. Each patient underwent emergency surgical repair, the former via left anterolateral thoracotomy and the latter via median sternotomy, following pericardial drainage tube insertion from the subxiphoid area. The operative approach was chosen according to the color of drained blood, i.e., arterial bleeding indicated left anterolateral thoracotomy, while venous bleeding indicated median sternotomy. We conclude that pericardial drainage via the subxiphoid approach prior to induction of anesthesia is an easy and useful technique to perform, not only to release cardiac tamponade but to determine the operative approach in patients suffering from cardiac tamponade following cardiac injury.

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Blunt Traumatic Rupture of the Heart and Pericardium:

Cited by 105 publications

References 0 publications

Five cases of blunt traumatic cardiac rupture: success and failure in surgical management

Five cases of blunt traumatic cardiac rupture: success and failure in surgical management

Blunt Traumatic Rupture of the Left Atrial Appendage

Pericardial drainage prior to operation contributes to surgical repair of traumatic cardiac injury

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