[Investigation of rescued cases with cardiac rupture caused by blunt trauma]

The mortality of cardiac rupture by blunt trauma is so high that quick diagnosis and appropriate treatment are essential for saving patients. Based on 8 such cases rescued in our hospital and on 70 other rescued cases reported in Japan, we review its treatment strategy. Ultrasound examination, particularly focused assessment with sonography for trauma (FAST), was useful for diagnosing traumatic cardiac rupture. It was, however, impossible to detect the exact site of rupture before surgery. Three quarters of the rescued cases suffered from right cardiac rupture and more than 95% of those were treated successfully without extracorporeal circulation. All the cases with multiple cardiac rupture needed cardiopulmonary bypass or percutaneous cardiopulmonary support (PCPS) for their surgeries. And so did a quarter of the cases with left cardiac rupture. The standard treatment strategy seems to be as follows:to release cardiac tamponade as slowly as possible, to set up an extracorporeal circulation for surgery, and to repair the ruptured heart via median sternotomy.