• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.180-186
• /
• 2023

Purpose: The purpose of this study was to report the treatment results of patients with traumatic cardiac tamponade after the opening of Jeju Regional Trauma Center. Methods: We analyzed the treatment outcomes of patients with traumatic cardiac tamponade who were treated at Jeju Regional Trauma Center from January 2018 to August 2022. Results: Seven patients with traumatic cardiac tamponade were treated. The male to female ratio was 1.33:1 (four male and three female patients) and the average age was 60.3±7.2 years. The mechanism of injury was blunt trauma in six cases and penetrating injury in one case. Upon arrival at the emergency department, pericardiostomy was performed in four cases, and an emergency operation was performed in six cases. Pericardiostomy alone was performed in one patient, who had cardiac tamponade due to extrapericardial suprahepatic inferior vena cava rupture. The causes of cardiac tamponade were right atrium appendage rupture in one case, right ventricle rupture in one case, inferior vena cava rupture in two cases, right atrium and left atrium rupture in one case, both atria and left ventricle rupture in one case, and intercostal artery rupture in one case. In three cases, intraoperative cardiopulmonary bypass was required. Two of the seven patients died (mortality rate, 28.5%). Conclusions: Relatively favorable treatment results were observed for traumatic cardiac tamponade patients after Jeju Regional Trauma Center was established.

• Journal of Trauma and Injury
• /
• v.24 no.2
• /
• pp.168-170
• /
• 2011

Blunt cardiac rupture is uncommon and is associated with significant mortality. Patients with blunt cardiac rupture usually have combined injury and do not always show signs of cardiac tamponade, which delays the diagnosis of cardiac rupture and increases mortality. We report a case of cardiac rupture diagnosed and treated by using only thoracic exploration based on clinical impression, with radiologic studies, including even echocardiography, showing negative results.

• Journal of Trauma and Injury
• /
• v.27 no.1
• /
• pp.5-8
• /
• 2014

Although blunt traumatic cardiac rupture is an uncommon injury, it can be associated with a high mortality rate. Two cases of cardiac rupture in blunt trauma patients are described herein. In those cases, applications of mechanical support devices such as ECMO (extracorporeal membrane oxygenation) and early surgery for exploration under cardiopulmonary bypass may be helpful for treating blunt chest trauma patients.

• Journal of Chest Surgery
• /
• v.49 no.6
• /
• pp.435-442
• /
• 2016

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.

• Journal of Chest Surgery
• /
• v.24 no.10
• /
• pp.987-992
• /
• 1991

Severe cardiac injury due to nonpenetrating blunt chest trauma is not uncommon, but survival to reach the hospital is rare. Successful management of fatal cardiac rupture depends on the high suspicion and on the prompt exploration. In the patient presented, the interatrial septal rupture was found associated with the right atrial rupture and the patient was successfully treated under the cardiopulmonary bypass. Although many types of cardiac rupture cases survived have been reported in the literature, we have been unable to find the interatrial septal rupture case like us. We would therefore like to report our experience with surgical repair of nonpenetrating rupture of right atrium and interatrial septum.

• Journal of Chest Surgery
• /
• v.20 no.2
• /
• pp.427-431
• /
• 1987

A case is presented of a steering wheel Injury to the chest which developed right atrial free wall rupture and cardiac tamponade without rib fractures or hemo-pneumothorax. A 30 year old man who sustained, blunt chest trauma by steering wheel injury to his chest developed right atrial rupture and cardiac tamponade. Pericardiocentesis was performed and cardiac tamponade was confirmed. After a median sternotomy, large right atrial free wall laceration [about 8cm] was noted. He was placed on cardiopulmonary bypass. The laceration wound of right atrium was closed with a 2 rows of continuous suture. Recovery was uneventful. The patient has returned to his previous level of activity.

• Journal of Chest Surgery
• /
• v.28 no.6
• /
• pp.630-632
• /
• 1995

Bichamber cardiac rupture is less frequent compared to unichamber cardiac rupture. We report a patient who was successfully treated after the diagnosis of penetrating stab wound of both ventricles. The key to improved outcome of management of cardiac trauma lies in the rapid transportation to a general hospital where cardiac surgery is available. Aggressive primary intervention and immediate operation are also major factors.

• Journal of Trauma and Injury
• /
• v.34 no.3
• /
• pp.183-186
• /
• 2021

Cardiac tamponade is an acute life-threatening condition that predominantly involves the intra-pericardial space; however, an expanding mediastinal hematoma can also sometimes cause cardiac tamponade. Here we describe the case of a 45-year-old male driver in whom a traffic accident resulted in rupture of the left internal thoracic artery (ITA), extra-pericardial hematoma, and sternal fracture. After resuscitation, he was scheduled to undergo angio-embolization to repair the ruptured left ITA, but he suddenly developed cardiac tamponade that required a decompressive sternotomy. Nevertheless, the patient had an uncomplicated recovery, and this case suggests that extra-pericardial cardiac tamponade should be considered as a possible consequence of retro-sternal hematoma due to traumatic ITA rupture.

• Journal of Trauma and Injury
• /
• v.25 no.4
• /
• pp.287-290
• /
• 2012

Cardiac rupture after blunt trauma is very rare and caval injury is even rarer. However, cardiac rupture after blunt trauma is associated with very high mortality and can occur without a high speed collision or severe thoracic injury. Symptoms are not expressed in all patients in the early stage, so the condition is easily overlooked if patients have an associated injury, minimal thoracic injury or relatively stable vital signs. We report the successful management of two cases of vena caval injury after blunt trauma with slight thoracic injury.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1398-1400
• /
• 1996

The cardiac anatomic position immediately beneath the sternum leaves it vulnerable to injury when this bone is fractured. Cardiac rupture, however, is uncommon but survival following this injury is rare. We report the case of one patient who survived right ventricle perforation resulting from sternal fracture. The patient developed signs of pericardial tamponade and was brought to the operating theatre immediately for surgery through the emergency anterolateral thoracotomy Perforation of th right ventricle was repaired by direct closure without cardiopulmonary bypass. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and surgery.