Delayed revascularization following complete transection of left anterior descending artery after a stab wound
Petr Santavy1, Andrea Steriovsky1, Vladimir Lonsky1
1Department of Cardiac Surgery, Palacky University, Olomouc, Czech Republic.
Insights
Penetrating heart injuries from stab wounds are often fatal, but this case shows successful off-pump revascularization for coronary artery transection. Mild symptoms in stab-wound victims with heart injury warrant prompt clinical evaluation and management.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Emergency Medicine
Background:
- Penetrating cardiac trauma, particularly from stab wounds, is frequently fatal.
- Mild symptoms can mask severe injuries like coronary artery transection.
- Prompt clinical suspicion and management are crucial for survival.
Purpose of the Study:
- To report a rare case of successful off-pump revascularization for stab-wound-induced coronary artery transection.
- To highlight the potential for mild symptoms in severe cardiac trauma.
- To review the management of traumatic coronary artery injuries.
Main Methods:
- Case report of a patient with penetrating cardiac trauma and left anterior descending coronary artery transection.
- Successful surgical revascularization performed off-pump (without cardiopulmonary bypass).
- Literature review on the management of traumatic coronary artery injury.
Main Results:
- Complete coronary artery transection due to a stab wound was successfully treated.
- Off-pump revascularization proved to be a safe and effective approach.
- The patient presented with surprisingly mild symptoms despite the severe injury.
Conclusions:
- Coronary artery transection from penetrating trauma can be managed successfully with off-pump revascularization.
- Mild symptoms should not preclude thorough investigation for cardiac injury.
- This case expands the literature on managing traumatic coronary artery injuries.
Introduction:
Penetrating heart injury as a consequence of a stab wound is usually considered fatal. Nevertheless, there are rare lucky cases with mild symptoms which deserve clinical suspicion and proper management.
Presentation Of Case:
We report a penetrating cardiac trauma with left anterior descending coronary artery transection after a stab wound. Successful revascularization without cardiopulmonary bypass support was performed.
Discussion:
Coronary artery injuries after penetrating cardiac trauma are mostly fatal. The standard approach has traditionally been coronary artery ligation with serious morbidity. We report a case of complete coronary artery transection with delayed revascularization validating the safety of off-pump approach. We add a short literature review of the management of traumatic coronary artery injury.
Conclusion:
This adds to the world literature on coronary artery trauma with successful off-pump revascularization. Coronary artery transection stab-wound victims can have only mild symptoms. Slightest intimation of heart injury should provoke proper clinical examination and management.
More Related Videos
13:10Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
Published on: April 24, 2017
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019