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Published on: June 12, 2021
Great vessel and cardiac trauma
Chris C Cook1, Thomas G Gleason
1Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center Heart, Lung, and Esophageal Surgery Institute, PUH C-800, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Insights
This review covers diagnosing and managing thoracic great vessel and cardiac trauma, including blunt aortic, nonaortic great vessel, and cardiac injuries. It highlights advances in imaging and less-invasive treatments, while emphasizing open surgery
Area of Science:
- Trauma surgery
- Cardiovascular surgery
- Thoracic surgery
Background:
- Thoracic great vessel and cardiac trauma require precise diagnosis based on injury location and mechanism (blunt or penetrating).
- Management strategies are tailored to the specific injury extent and type.
- Recent advancements in imaging and catheter-based interventions offer improved diagnostic accuracy and less invasive treatment options.
Purpose of the Study:
- To review the diagnosis and management of blunt aortic injuries, nonaortic great vessel injuries, blunt cardiac injuries, and penetrating cardiac injuries.
- To discuss the evolving role of endovascular techniques versus traditional open surgical repair.
- To highlight the importance of a multidisciplinary team approach in managing complex thoracic trauma.
Main Methods:
- Literature review focusing on diagnosis and management strategies for thoracic great vessel and cardiac trauma.
- Analysis of current imaging modalities and endovascular techniques.
- Discussion of open surgical repair as a definitive treatment.
Main Results:
- Advances in imaging and catheter-based technologies facilitate more accurate diagnosis and less-invasive treatments.
- Open surgical repair remains the definitive treatment for many significant thoracic injuries.
- Multidisciplinary team models are increasingly adopted for managing multitrauma patients.
Conclusions:
- Effective management of thoracic great vessel and cardiac trauma necessitates a comprehensive understanding of injury mechanisms and anatomical locations.
- A combination of advanced diagnostic tools, less-invasive interventions, and traditional surgery, guided by a multidisciplinary approach, optimizes patient outcomes.
- Continued evolution of treatment strategies balances technological advancements with established surgical principles.
Abstract:
Thoracic great vessel and cardiac trauma are characterized by anatomic location and mechanism of injury: blunt or penetrating. Management strategies are also directed by the extent and mechanism of injury. Advances in imaging and catheter-based technologies have allowed easier and more accurate diagnosis and less-invasive treatments. Although the advantages of endovascular techniques are attractive, open surgical repair remains the definitive treatment for many of these thoracic injuries. Given the increasing sophistication of these technologies and the demonstrated usefulness of a disease-oriented approach toward patient management, trauma centers have adopted a multidisciplinary team model for management of multitrauma victims. In this review, the authors detail the diagnosis and management of blunt aortic, nonaortic great vessel, blunt cardiac, and penetrating cardiac injuries.
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