Great Vessel and Cardiac Trauma: Diagnostic and Management Strategies

Navid, Forozan; Gleason, Thomas G.

doi:10.1053/j.semtcvs.2007.11.007

Cited by 50 publications

(68 citation statements)

References 44 publications

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“…The right ventricle was the most frequently injured cardiac chamber (40.3%). The same data are provided by other authors [4,16,21,24].…”

Section: Discussionmentioning

confidence: 97%

“…In fact, the number of casualties with fatal outcome prior to admission is not known to us; however, some authors suggest that only 6-20% of victims reach hospital alive. The overall survival rate of penetrating heart trauma is estimated to be 10-92% [3,16,21,[24][25][26][27]. It depends not only on the severity of the injury but on other circumstances as well (population area, median time taken from injury to emergency department admission, associated injuries, etc.…”

Section: Discussionmentioning

confidence: 99%

“…The data in the literature are controversial. Some authors prefer longitudinal sternotomy [14,15,21,24], while others advocate for thoracotomy, especially for patients in a terminal condition [3,22,23,25,27,29]. According to Kang et al [4], the easiest way to reach the heart is longitudinal sternotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Heart injury severity score was evaluated according to the American Association for the Surgery of Trauma (AAST) Heart injury scale, which includes six grades [15,21,22].…”

Section: Methodsmentioning

confidence: 99%

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CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Jagelavičius¹,

Budra²,

Jovaišas³

et al. 2013

kitp

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1 StreszczenieWstęp: Rany kłute serca są dramatycznymi, prowadzącymi do zgonu urazami. Na ogół zdarzają się u ludzi młodych. Więk-szość ofiar umiera przed przyjęciem do szpitala. Cel pracy: Celem pracy było określenie czynników decydują-cych o wynikach leczenia i rokowaniu chorych z ranami kłu-tymi serca. , p = 0,031), wyższy stopień urazu (IV-VI) (90,5% vs 29,7%, p < 0,001), uraz prawego przedsionka (28,6% vs 8,5%, p = 0,014) lub lewej komory (42,9% vs 23,0%, p = 0,049) i epizody zatrzymania krążenia (85,7% vs 7,9%, p < 0,001). Niezależnym prognostycznym czynnikiem przeżycia była obecność wszystkich czynników SOL oraz młodszy wiek. Wyższy stopień urazu (IV-VI) oraz zatrzymanie krążenia w trakcie operacji były niezależnymi czynnikami zgonu. Wnioski: Prekursorami złego rokowania były niższe wartości ciśnienia tętniczego oraz brak co najmniej jednego z czynni- CARDIAC SURGERY AbstractBackground: Penetrating cardiac injuries are a dramatic and lethal form of trauma. They are usually sustained by young people. The majority of victims die before reaching the hospital. Aim of the study: The aim of the study was to establish prognostic criteria for the outcome of penetrating cardiac injury. Material and methods: We retrospectively reviewed the records of 186 patients with penetrating cardiac injuries who were operated on during the first 24 hours after admission. Results: The mean age was 33 (interquartile range (IQR): 26-44) years. 88.7% of victims were male. The mean time from the moment of trauma to arrival at the hospital in Vilnius city was 60 minutes (IQR: 50-91), whereas from the Vilnius region it was 240 (IQR: 82-390) minutes. The vast majority of patients (176/186, 94.6%) sustained stab wounds. Hemopericardium or cardiac tamponade (142/186, 76.3%) usually was found at the operation. Right ventricle was the most often injured heart chamber (75/186, 40.3%). Associated injuries were evaluated in 57.0% (106/186) of patients. The survival rate on discharge was 88.7%. Compared to non-survivors, the lucky patients had a higher systolic blood pressure on admission (94 mm Hg (IQR: 70-120) versus (vs.) 70 mm Hg (IQR: 0-80), p < 0.001). Survivors had all signs of life (SOL) more often (82.4% vs. 42.9%, p < 0.001), whereas more frequent findings in non-survivors were the following: tamponade (52.4% vs. 29.1%, p = 0.031), higher grade (IV-VI) of injury (90.5% vs. 29.7%, p < 0.001), injured right atrium (28.6% vs. 8.5% p = 0.014) or left ventricle (42.9% vs. 23.0%, p = 0.049) and an episode of heart arrest (85.7% vs. 7.9%, p < 0.001). Independent prognostic factors of survival were the presence of all SOL and younger age. Higher grade (IV-VI) of heart injury and heart arrest during surgery independently predicted mortality. Conclusions: According to our data, lower arterial blood pressure and absence of one or more SOL on admission, cardiac tamponade, higher grade injury, injured right atrium and asystole during operation are true precursors of fatal outcome.

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“…The right ventricle was the most frequently injured cardiac chamber (40.3%). The same data are provided by other authors [4,16,21,24].…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Heart injury severity score was evaluated according to the American Association for the Surgery of Trauma (AAST) Heart injury scale, which includes six grades [15,21,22].…”

Section: Methodsmentioning

confidence: 99%

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CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Jagelavičius¹,

Budra²,

Jovaišas³

et al. 2013

kitp

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“…2,3 To our knowledge, this is the first reported case of penetrating trauma to the ascending aorta by barbed wire.…”

Section: Introductionmentioning

confidence: 99%

Trauma of the Ascending Aorta by Barbed Wire: A Rare Mechanism

Basso¹,

Fontana²,

Finger³

et al. 2013

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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We report a case of ascending aortic trauma, in a 60 years old patient by barbed wire. Primary exam revealed Beck's triad, generating the hypothesis of a cardiac tamponade, which was confirmed with FAST. It was quickly performed a laparotomy in order to discard abdominal injuries, including pericardical window, followed by sternotomy which confirmed the laceration of ascending aorta. Primary suture of the lesion was performed and the patient evolved well postoperatively. To our knowledge, this is the first reported case of penetrating trauma to the ascending aorta by barbed wire.

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Predicting mortality in penetrating cardiac trauma in developing countries through a new classification: Validation of the Bogotá classification

Pulido

Reyes

Enríquez

et al. 2022

Health Science Reports

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Introduction Penetrating chest trauma (PCT) represents 10% of worldwide mortality, with developing countries counting as some of the most affected by high mortality rates due to cardiac trauma. Colombia is considered one of the most violent countries due to the high mortality rate associated with war and crime, hence the validation of an own classification for penetrating cardiac injuries (PCI) is mandatory. Methods Retrospective cross‐sectional study which included adult patients with PCIs at a level 4 trauma center in Colombia, between January 2018 and April 2020. We used our own system (Bogotá Classification) and compared it with traditional systems (e.g., Ivatury's, OIS‐AAST), by analyzing the mechanism of injury (MOI), the hemodynamic status of the patient at admission, the inpatient management, the individual outcomes, and some demographic variables. Bivariate statistical analysis, spearman correlation, and logistic regression were performed. Results Four hundred and ninety‐nine patients were included. Bivariate analysis demonstrated a significant relationship between mortality and hemodynamic state, MOI, its location and degree of lesion, cardiac/vessel injury, cardiac tamponade, time between injury and medical care, fluid reanimation, as well as the Ivatury's classification and the new classification (p < 0.005). The adequate correlation between Ivatury's and Bogotá classification supports the latter's clinical utility for patients presenting with PCI. Likewise, logistic regression showed a statistically significant association among mortality rates (p < 0.005). Conclusions The Bogotá classification showed similar performance to the Ivatury's classification, correlating most strongly with mortality. This scale could be replicated in countries with similar social and economic contexts.

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Great Vessel and Cardiac Trauma: Diagnostic and Management Strategies

Cited by 50 publications

References 44 publications

CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Trauma of the Ascending Aorta by Barbed Wire: A Rare Mechanism

Predicting mortality in penetrating cardiac trauma in developing countries through a new classification: Validation of the Bogotá classification

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