Cardiac Trauma

Gosavi, Sucheta; Tyroch, Alan; Mukherjee, Debabrata

doi:10.1177/0003319715627954

Cited by 27 publications

(33 citation statements)

References 47 publications

(51 reference statements)

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“…Ножевые ранения аорты -опасное и крайне нестабильное состояние, требующее немедленного хирургического вмешательства. Проникающие ранения грудной аорты имеют высокую летальность (90 %) [9]. Однако большинство описанных в литературе случаев ранения стенки грудной аорты связаны с ятрогенными осложнениями [8; 10; 11].…”

Section: Discussionunclassified

“…Однако большинство описанных в литературе случаев ранения стенки грудной аорты связаны с ятрогенными осложнениями [8; 10; 11]. Иногда разрыв аорты задерживается адвентицией или периаортальной тканью, что приводит к формированию ложной аневризмы аорты [9]. В описанном клиническом случае в анамнезе у пациента в 2017 г. было ранение левых легкого и желудочка.…”

Section: Discussionunclassified

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A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

Петлин¹,

Косовских²,

Козлов³

et al. 2021

PKiK

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Chest injury is an acute, extremely life-threatening condition. Among penetrating heart wounds, approximately 85% are stab wounds. In the case of stab and cut injuries, the lethality, according to various sources, reaches 90% and directly depends on the time of delivery of the victim to the hospital. In the overwhelming majority of cases, emergency operations for stab wounds of the chest are conducted in general surgical hospitals. As a rule, when providing emergency surgical care, only superficial heart wounds are sutured, excluding the correction of damage to the intra-cardiac structures. Aorto-right atrial fistula is a rather rare clinical condition that is formed due to the action of a traumatic factor and is characterised by the formation of a communication between the aorta and the right atrium with the discharge of arterial blood into the venous system. Considering that this pathology is accompanied by an increase in pressure in the right atrium, signs of stagnation are found in the systemic circulation, followed by compensatory dilatation of the right atrium and then dilatation of the right ventricle. The only effective method to treat this problem is surgery. The presented clinical case demonstrates the surgical treatment of chronic post-traumatic aorto-right atrial fistula, pseudo-aneurysm between the non-coronary sinus and the right atrium and pseudo-aneurysm of the left coronary sinus 2 years after the stab wound. Echocardiography performed after surgery indicated a positive trend, i.e., a decrease in the size of the right- and left-sided heart and normalisation of pressure in the pulmonary artery. No inter-chamber shunts were found. This case shows that clinicians must remember that after providing emergency surgical care to patients with penetrating chest wounds, it is necessary to conduct an additional examination of the heart after stabilisation of the condition to detect hidden damage to the intra-cardiac structures.Received 2 February 2021. Revised 2 March 2021. Accepted 3 March 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.

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Section: Discussionunclassified

A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

Петлин¹,

Косовских²,

Козлов³

et al. 2021

PKiK

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“…Assessing traumatic cardiac injury is often challenging, and the presentation of injured myocardium can range from asymptomatic to cardiogenic or hypovolemic shock or both. Mortality secondary to blunt or penetrating cardiac trauma remains high despite improvements in diagnostic technologies 45 46. Compared with patients without pulmonary contusions, those with pulmonary contusions have been reported to have a higher risk for post-traumatic acute respiratory distress syndrome,47 and even minor pulmonary injuries are associated with a higher mortality rate 48.…”

Section: Discussionmentioning

confidence: 99%

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

Kuo

Liao

et al. 2019

BMJ Open

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ObjectivesTo assess the impact of lower socioeconomic status on the outcome of major torso trauma patients under the single-payer system by the National Health Insurance (NHI) in Taiwan.DesignA nationwide, retrospective cohort study.SettingAn observational study from the NHI Research Database (NHIRD), involving all the insurees in the NHI.ParticipantsPatients with major torso trauma (injury severity score ≥16) from 2003 to 2013 in Taiwan were included. International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify trauma patients. A total of 64 721 patients were initially identified in the NHIRD. After applying the exclusion criteria, 20 009 patients were included in our statistical analysis.Primary and secondary outcome measuresThe primary outcome measure was in-hospital mortality, and we analysed patients with different income levels and geographic regions. Multiple logistic regression was used to control for confounding variables.ResultsIn univariate analysis, geographic disparities and low-income level were both risk factors for in-hospital mortality for patients with major torso trauma (p=0.002 and <0.001, respectively). However, in multivariate analysis, only a low-income level remained an independent risk factor for increased in-hospital mortality (p<0.001).ConclusionEven with the NHI, wealth inequity still led to different outcomes for major torso trauma in Taiwan. Health policies must focus on this vulnerable group to eliminate inequality in trauma care.

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“…Traumatic cardiac injuries are rare and are usually associated with a high mortality rate. To save a patient with a blunt or penetrating cardiac injury, rapid diagnosis, decisions, and treatment by an experienced surgeon is mandatory [1]. The Advanced Trauma Operative Management (ATOM) course, which is a program of the American College of Surgeons and administered in Japan through the Japan Surgical Society, is a 1-day trauma course that includes a series of lectures and live-animal surgery simulation training with pigs to teach the surgical management of penetrating traumatic injuries [2].…”

Section: Introductionmentioning

confidence: 99%

The importance of simulation education for the management of traumatic cardiac injuries: a case series

et al. 2019

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BackgroundThe management of cardiac trauma requires rapid intervention in the emergency room, facilitated by a surgeon with prior experience to have good outcomes. Many surgeons have little experience in the requisite procedures. We report here 4 patients who suffered cardiac trauma, and all 4 patients survived with good neurologic outcomes.Case presentationsPatient 1 suffered blunt cardiac trauma from a motor vehicle accident and presented in shock. Cardiac tamponade was diagnosed and a cardiac rupture repaired with staples through a median sternotomy after rapid transport to the operating room. Patient 2 suffered blunt cardiac trauma and presented in shock with cardiac tamponade. Operating room median sternotomy allowed extraction of pericardial clot with recovery of physiologic stability. Patient 3 presented with self-inflicted stab wounds to the chest and was unstable. She was brought to the operating room and thoracotomy allowed identification of a left ventricle wound which was repaired with a suture. Patient 4 presented in cardiac arrest with multiple self-inflicted stab wounds to the chest. Emergency room thoracotomy allowed repair of a right ventricle laceration with recovery of vital signs.ConclusionsThe management of all 4 patients was according to the principles taught in the ATOM course. Three of the 4 surgeons had no prior experience with management of cardiac trauma and credited the good outcomes to taking the ATOM course. These are uncommon injuries and formal training in their management is beneficial to patients.

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Cardiac Trauma

Cited by 27 publications

References 47 publications

A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

A clinical case of surgical treatment of a knife-penetrated wound of the right atrium and the aortic root 2 years after the injury

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

The importance of simulation education for the management of traumatic cardiac injuries: a case series

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