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[Experience of Surgical Repair for Cardiac Trauma]
1Department of Cardiovascular Surgery, Hiraka General Hospital, Yokote, Japan.
Insights
This study details surgical repair of cardiac trauma in 7 patients, highlighting direct suture closure as a primary method. Trauma and Injury Severity Score (TRISS) effectively evaluated survival probability in these critical cases.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Emergency Medicine
Background:
- Cardiac trauma presents a high mortality rate.
- Prompt surgical intervention is crucial for survival.
- Understanding injury patterns aids treatment strategies.
Observation:
- Seven patients with cardiac injuries underwent surgical repair.
- Mechanisms included blunt (5) and penetrating (2) trauma.
- Injured chambers: right atrium (2), right ventricle (2), left atrium (1), left ventricle (1), and right ventricle/ascending aorta (1).
Findings:
- Direct suture closure was the primary repair technique for all wounds.
- One patient with complex injury (right ventricle/ascending aorta) required cardiopulmonary bypass (CPB).
- Mortality was linked to severe hemorrhage, with one fatality due to retroperitoneal bleeding.
Implications:
- Direct suture closure is effective for various cardiac injuries.
- CPB may be necessary for extensive cardiac and aortic trauma.
- TRISS provides a reasonable assessment of trauma severity and survival prognosis.
Abstract:
Cardiac trauma is one of the most lethal injuries. We reported 7 patients with cardiac injuries who underwent surgical repair. They were 4 men and 3 women with a mean age of 64 years. The mechanisms of injuries were blunt trauma by traffic accident in 5 patients and penetrating trauma in 2 patients. The injured cardiac chambers were the right atrium in 2, the right ventricle in 2, the right ventricle and the ascending aorta in 1,the left atrium in 1 and the left ventricle in 1 patient. The wounds of all patients were repaired by direct suture closure. Only 1 patient with injuries in the right ventricle and the ascending aorta was repaired under cardiopulmonary bypass (CPB). The patient with right atrial rupture and concomitant pelvic bone fructure died of retroperitoneal hemorrhage. According to the analysis by Trauma and Injury Severity Score( TRISS), probability of survival(Ps) values ranged from 0.002 to 0.978. A patient with a Ps value of 0.002 died of bleeding. Evaluation of the severity of trauma and injury by TRISS was considered generally reasonable.
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