Long-Term Functional and Echocardiographic Assessment After Penetrating Cardiac Injury: 5-Year Follow-Up Results

Carr, John Alfred; Buterakos, Roxanne; Bowling, William M.; Janson, Lisa; Kralovich, Kurt A.; Copeland, Craig F; Link, Renée; Roiter, Cecilia; Casey, Gregory; Wagner, James W.

doi:10.1097/ta.0b013e31820c405a

Cited by 19 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No valvular or septal pathology was detected. As these patients are usually young and valvular pathology might appear later [ 28 ], we suggest echocardiographic follow-up after 1 and 3 years for patients with transmural heart injuries. This was not routinely done in our survivors.…”

Section: Discussionmentioning

confidence: 99%

Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center

Kaljusto

Skaga

Pillgram-Larsen

et al. 2015

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

BackgroundPenetrating cardiac injuries in Europe have been poorly studied. We present a 10-year outcome for patients with penetrating heart injuries at Oslo University Hospital.MethodsData from 01.01.2001 until 31.12.2010 was collected from the Oslo University Hospital Trauma Registry and from the patients’ records.ResultsThirty-one patients were admitted with a penetrating cardiac injury. Fourteen patients survived (45 %). Four out of 8 patients (50 %) with gunshot wounds survived compared to 10 out of 23 (44 %) with stab wounds. Median (quartiles) for the following values were: Injury Severity Score 25 (21–35), Revised Trauma Score 0 (0–6,9), Probability of Survival 0,015 (0,004–0,956), Glasgow Coma Scale 3 (3–13). Thirteen patients had signs of life on admission and survived. Eighteen patients were admitted without signs of life and received emergency department thoracotomy. Eight of these had no signs of life at the scene of injury and did not survive. Out of the remaining 10 patients, one survived.ConclusionsThe outcome of patients with penetrating cardiac injury reaching the emergency department with signs of life was excellent. Hemodynamic instability indicates immediate surgery. Stable patients with penetrating thoracic trauma and possible cardiac injury detected by imaging should be considered for conservative treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center

Kaljusto

Skaga

Pillgram-Larsen

et al. 2015

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…We noticed while attempting to create an animal model of muscular ventricular septal defect, that aggressive dilatation without ablation of the interventricular septum failed to induce a persistent defect or shunt [9]. Moreover, knife injury across the interventricular septum often fails to induce persistent myocardial defects once hemopericardium is treated [10,11]. Liu and colleagues [12] report a different surgical approach to the LV across the RV free wall and interventricular septum in animals.…”

Section: Introductionmentioning

confidence: 99%

Transthoracic delivery of large devices into the left ventricle through the right ventricle and interventricular septum: preclinical feasibility

Halabi

Ratnayaka

Faranesh

et al. 2013

Journal of Cardiovascular Magnetic Resonance

View full text Add to dashboard Cite

BackgroundWe aim to deliver large appliances into the left ventricle through the right ventricle and across the interventricular septum. This transthoracic access route exploits immediate recoil of the septum, and lower transmyocardial pressure gradient across the right versus left ventricular free wall. The route may enhance safety and allow subxiphoid rather than intercostal traversal.MethodsThe entire procedure was performed under real-time CMR guidance. An “active” CMR needle crossed the chest, right ventricular free wall, and then the interventricular septum to deliver a guidewire then used to deliver an 18Fr introducer. Afterwards, the right ventricular free wall was closed with a nitinol occluder. Immediate closure and late healing of the unrepaired septum and free wall were assessed by oximetry, angiography, CMR, and necropsy up to four weeks afterwards.ResultsThe procedure was successful in 9 of 11 pigs. One failed because of refractory ventricular fibrillation upon needle entry, and the other because of inadequate guidewire support. In all ten attempts, the right ventricular free wall was closed without hemopericardium. There was neither immediate nor late shunt on oximetry, X-ray angiography, or CMR. The interventricular septal tract fibrosed completely. Transventricular trajectories planned on human CT scans suggest comparable intracavitary working space and less acute entry angles than a conventional atrial transseptal approach.ConclusionLarge closed-chest access ports can be introduced across the right ventricular free wall and interventricular septum into the left ventricle. The septum recoils immediately and heals completely without repair. A nitinol occluder immediately seals the right ventricular wall. The entry angle is more favorable to introduce, for example, prosthetic mitral valves than a conventional atrial transseptal approach.

show abstract

“…In the literature there are many PHI case reports and patient series, but there are few articles about their longterm follow-up. 4 There are some literature data indicating VSD, valve injury, or aneurysm or pseudoaneurysm formation during the long-term follow-up. But this is the first report demonstrating a case with combined VSD and AR because of leaflet perforation diagnosed 5 years after PHI.…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Regurgitation and Ventricular Septal Defect Diagnosed 5 Years after Penetrating Cardiac İnjury

Özdemir

Yüksel

Hüseyın

et al. 2013

Thorac cardiovasc Surg

View full text Add to dashboard Cite

Despite high mortality rates for penetrating heart injuries, developments in transport, diagnosis, and surgical interventions have increased survival rates. In some cases, life-threatening complications may be misdiagnosed or remain asymptomatic and lead to loss of life. Herein, we report a patient with aortic valve regurgitation because of noncoronary cusp perforation and ventricular septal defect that remained asymptomatic and diagnosed 5 years after a penetrating heart injury.

show abstract

Long-Term Functional and Echocardiographic Assessment After Penetrating Cardiac Injury: 5-Year Follow-Up Results

Cited by 19 publications

References 21 publications

Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center

Survival predictor for penetrating cardiac injury; a 10-year consecutive cohort from a scandinavian trauma center

Transthoracic delivery of large devices into the left ventricle through the right ventricle and interventricular septum: preclinical feasibility

Aortic Valve Regurgitation and Ventricular Septal Defect Diagnosed 5 Years after Penetrating Cardiac İnjury

Contact Info

Product

Resources

About