Surgical Treatment for a Trauma-Caused Cardiac Rupture
10.4326/jjcvs.35.132
- VernacularTitle:鈍的外傷による心破裂に対する外科治療
- Author:
Manabu Itoh
;
Kojiro Furukawa
;
Yukio Okazaki
;
Satoshi Ohtsubo
;
Junichi Murayama
;
Shugo Koga
;
Tsuyoshi Itoh
- Publication Type:Journal Article
- Keywords:
PCPS
- From:Japanese Journal of Cardiovascular Surgery
2006;35(3):132-135
- CountryJapan
- Language:Japanese
-
Abstract:
The survival rate of patients with cardiac rupture due to a blunt trauma is low, therefore it is necessary to have a well-defined diagnostic and treatment plan in order to improve the survival rate. In 8 such patients transthoracic echocardiograms at the time of arrival at our hospital showed pericardial effusion with cardiac tamponade in all patients. The mean time between suffering the injury and arriving at the hospital was 186±185min, and the mean time between arrival and being brought to the operating room was 82±49min. Preoperative pericardial drainage was performed in 2 patients, and percutaneous cardiopulmonary support system was used in 2 patients. The rupture site was in the right atrium in 3 patients, the right atrium-inferior vena cava in 1 patient, the right ventricle in 2 patients, the left atrium in 1 patient, and the left ventricle in 1 patient. Extracorporeal circulation was used in 4 patients, and the injured site was repaired. We were thus able to save the lives of 6 of the 8 patients (survival rate 75%). Transthoracic echocardiography was easy to perform and effective for making an accurate diagnosis. Many such patients tend to have multiple traumas, but, if the patient is in a state of shock due to cardiac tamponade, the patient should be moved immediately to the operating room. It is important to provide circulatory maintenance until surgery, and pericardial drainage and PCPS are also effective additional treatment modalities.
