Protective Effect of Previous Cardiac Operation: Survival of Contained Right Ventricular Rupture

Wilbring, Manuel; Tugtekin, Sems Malte; Daubner, Dirk; Ouda, Ahmed; Kappert, Utz; Matschke, Klaus

doi:10.1016/j.athoracsur.2012.09.043

Cited by 6 publications

(10 citation statements)

References 4 publications

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“…However, management of the rare cases in which cardiac rupture occurs in a patient with a previous sternotomy is not clear. Previous reports have postulated that poststernotomy adhesions may offer a protective effect on the heart, preventing the development of tamponade and restricting the extent of hemorrhage expansion, allowing for conservative management and avoiding the high risks of redo sternotomy . In our case, this may have allowed for the significant transport time required from remote hospital to trauma center with hemodynamic stability.…”

Section: Commentmentioning

confidence: 74%

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Survival Following Traumatic Ventricular Rupture and Prolonged Ambulance Transport in a Patient With Previous Coronary Artery Bypass Surgery

2013

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Patients presenting with traumatic cardiac rupture are unlikely to survive lengthy transfers from the trauma scene to a hospital. However, in patients with a previous sternotomy, adhesions may divert cardiac hemorrhage, allowing hemodynamic management to be successful. We present an 83-year-old male with a history of coronary artery bypass grafting (CABG) who sustained a right ventricular rupture. He underwent an immediate redo sternotomy and was discharged 10 days postoperatively with no complications.

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Section: Commentmentioning

confidence: 74%

“…Survival with emergent surgical management (redo sternotomy) has only been described in one previous case . The remaining few cases have described conservative nonoperative management with variable outcomes …”

mentioning

confidence: 99%

Survival Following Traumatic Ventricular Rupture and Prolonged Ambulance Transport in a Patient With Previous Coronary Artery Bypass Surgery

2013

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“…Towards this end, it has been reported that medical treatment of chronic pseudoaneurysm (defined as lasting >3 months) is not associated Case Reports in Cardiology with increased risk for mortality [1]. It is possible that there may exist a stabilizing effect of previous pericardial adhesions (to contain progression of growth) in this particular cohort where acute rupture is avoided [15]. In the specific instance of right ventricular involvement following motor vehicle collision, it has as well been hypothesized that there is decreased frequency of persistent right heart failure due to decreased right-sided wall strain affording a protective factor towards morbidity and mortality [14].…”

Section: Discussionmentioning

confidence: 99%

“…Following a literature review, published case reports of these right ventricular anomalies have been demonstrated to develop from lipoma [5], postcardiac surgery [6][7][8][9], following device lead extraction [10], in the infectious setting [11,12], after remote myocardial infarction [2], as a complication of endomyocardial biopsy [3], and subsequent to penetrating chest wall trauma [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

An Incidentally Detected Right Ventricular Pseudoaneurysm

Gaddipati

Martin

Valenzuela

et al. 2017

Journal of the American College of Cardiology

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Ventricular pseudoaneurysm is an uncommon, potentially fatal complication that has been associated with myocardial infarction, cardiac surgery, chest trauma, and infectious processes. Diagnosis can be challenging, as cases are rare and slowly progressing and typically lack identifiable features on clinical presentation. As a result, advanced imaging techniques have become the hallmark of identification. Ahead, we describe a patient who presents with acute decompensated heart failure and was incidentally discovered to have a large right ventricular pseudoaneurysm that developed following previous traumatic anterior rib fracture.

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“… 6 The existence of a previous sternotomy, proves to be a factor that increases the mortality (mostly due to pericardial adhesions). 6–8 …”

Section: Introductionmentioning

confidence: 99%

Post-trauma “abrasive” right ventricular rupture without mediastinitis early post-CABG. Is the Robicsek closure technique necessary for all elderly patients?

Georgiou

Patris

Lama

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONRight ventricular (RV) rupture with mediastinitis, is a very rare but extremely dangerous (even fatal) complication, following CABG surgery.PRESENTATION OF CASEIn this paper, we present the case of a post-trauma (after fall) RV rupture (without mediastinitis) in a patient who had undergone cardiac surgery several days ago. The cause of the rupture proved to be a broken bone piece from the lower sternal edge.DISCUSSIONRV rupture post-operatively caused by broken bone pieces or bone dislocation may occur through two mechanisms: either penetration of the RV, or through the “sandpaper effect”. In order to prevent the rupture, we should be able to recognize patients with aggravating factors (age, weight) and choose intra-operatively a suitable closure technique.CONCLUSIONWe propose that the technique that could prevent such ruptures is the Robicsek technique.

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Protective Effect of Previous Cardiac Operation: Survival of Contained Right Ventricular Rupture

Cited by 6 publications

References 4 publications

Survival Following Traumatic Ventricular Rupture and Prolonged Ambulance Transport in a Patient With Previous Coronary Artery Bypass Surgery

Survival Following Traumatic Ventricular Rupture and Prolonged Ambulance Transport in a Patient With Previous Coronary Artery Bypass Surgery

An Incidentally Detected Right Ventricular Pseudoaneurysm

Post-trauma “abrasive” right ventricular rupture without mediastinitis early post-CABG. Is the Robicsek closure technique necessary for all elderly patients?

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