Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years.
10.5090/kjtcs.2016.49.6.435
- Author:
Jeong Hee YUN
1
;
Joung Hun BYUN
;
Sung Hwan KIM
;
Sung Ho MOON
;
Hyun Oh PARK
;
Sang Won HWANG
;
Yong Hwan KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Cardiac tamponade;
Trauma;
Rupture
- MeSH:
Accidents, Traffic;
Cardiac Tamponade;
Creatine;
Glasgow Coma Scale;
Heart Atria;
Heart Injuries*;
Heart Rupture;
Humans;
Injury Severity Score;
Mortality;
Platelet Count;
Retrospective Studies;
Rupture;
Survivors
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2016;49(6):435-442
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. METHODS: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. RESULTS: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase–myocardial band (CK-MB) levels (p=0.042) and platelet counts (p= 0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. CONCLUSION: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient’s life.
