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Successful surgical management of penetrating cardiac injury

S Yamada1, M Yamazaki, K Mori

  • 1Department of Surgery, Shimizu City Hospital, Shizuoka, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|December 16, 1998
PubMed

Insights

This case report details the successful emergency repair of a penetrating left ventricular injury and associated thoracoabdominal trauma. It highlights the critical management of cardiac injuries and the potential for delayed rupture.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Penetrating cardiac injuries are life-threatening emergencies requiring prompt surgical intervention.
  • Thoracoabdominal trauma presents complex challenges due to the proximity of vital organs.
  • Early diagnosis and management are crucial for patient survival and favorable outcomes.

Observation:

  • A 60-year-old male presented with penetrating thoracoabdominal injuries and shock.
  • Computed tomography (CT) indicated a left ventricular injury, necessitating emergency thoracotomy.
  • Initial repair of the left ventricular laceration, superior mesenteric artery, and small bowel was performed without cardiopulmonary bypass.

Findings:

  • The patient experienced cardiac arrest during surgery but recovered neurologically intact.
  • Postoperative echocardiogram, CT, and cardiac catheterization revealed a delayed rupture of the left ventricle.
  • The patient was transferred for elective cardiac surgery on postoperative day 28.

Implications:

  • This case underscores the importance of vigilant postoperative monitoring for delayed complications after penetrating cardiac injuries.
  • The successful management highlights the feasibility of repairing complex cardiac and vascular injuries, even in critical conditions.
  • Effective multidisciplinary care is essential for optimizing outcomes in patients with severe thoracoabdominal trauma and cardiac involvement.

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