• Journal of Chest Surgery
• /
• v.41 no.1
• /
• pp.95-97
• /
• 2008

Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.633-635
• /
• 2008

Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.

• Journal of Chest Surgery
• /
• v.40 no.1 s.270
• /
• pp.66-68
• /
• 2007

Traumatic cardiac injury is an extremely serious medical condition. It is possible to overlook a cardiac injury where there is no chest wall trauma. We here report the 47-year-old woman who got a crach car accident and had a tear of the right atrium. The distortion force from a decelerating injury may cause cardiac rupture at a fixed point. The most common symptom that alerts the clinician to a potentially fatal cardiac injury is the change in vital signs. Therefore cardiac injury should be considered in any patient with unexplained hypotension who has experienced decelerating trauma, even without external injury to the chest wall.

• Journal of Chest Surgery
• /
• v.50 no.6
• /
• pp.474-476
• /
• 2017

A 56-year-old woman, who underwent cardiac surgery 3 months previously, presented to the emergency room with pulmonary artery rupture due to the cytotoxic effects of BioGlue (CryoLife Inc., Kennesaw, GA, USA). She was successfully treated with surgical management. Although surgical glue can be effectively used for hemostasis, it can induce delayed vascular complications. Therefore, surgical glue should be used cautiously.

• Journal of Chest Surgery
• /
• v.21 no.3
• /
• pp.547-552
• /
• 1988

Rupture of the main bronchus followed by blunt chest trauma is comparatively very rare. Early recognition of bronchial rupture and emergency thoracostomy and management is essential for reducing of morbidity and mortality and late complications. This case was 11 years old female who was a primary school student. The patient was sustained a crushing injury to her right hemithorax by traffic accident and had been taken emergency closed thoracostomy at her second intercostal space, midclavicular line at emergency room. In the course of the next 2 hours, the girl`s condition remained critical with tension pneumothorax and abnormal arterial blood gas analysis. Induction of anesthesia started 3 hours after the accident. During the general anesthesia, cardiac arrest was occurred and cardiac resuscitation was performed. Right upper lobectomy and end-to-end anastomosis of ruptured right main bronchus was performed. Postoperative course was satisfactory.

• Journal of Chest Surgery
• /
• v.24 no.6
• /
• pp.616-624
• /
• 1991

Recently, cardiac injury due to blunt thoracic trauma appears to be increasing in frequency. The rising incidence of this mishap may relate to the absolute increase in automobile accidents as well as to more universal recognition that cardiac damage may have been sustained. We have experienced a rare case of ventricular septal defect caused by non-penetrating thoracic trauma. Of further interest is the history of chest trauma, clearly resulting in rupture of the chordae tendineae of the tricuspid valve successfully treated by operation-re-placement with two, 6 - 0, double-armed, expanded polytetrafluoroethylene sutures-2 months later. The unique combination of ventricular septal defect and rupture of the chordae tendineae of the tricuspid valve secondary to non-penetrating thoracic trauma is presented below to emphasize another variety of cardiac injury.

• Journal of Chest Surgery
• /
• v.9 no.1
• /
• pp.55-62
• /
• 1976

This is a report of 8 cases cardiac arrest developed in the operating room at Jeonbug university Hospital from January 1973 to October, 1975. Four patients of cardiac arrest developed during the elective operation, 3 during the emergency operation and the remaining one, bronchoscopy for foreign body removal under the general anesthesia. Immediate closed chest cardiac massage was performed in the 7 patients and the remaining one underwent open chest cardiac massage. Five of 7 patients with the closed chest cardiac massage regained consciousness and restored respiration, but 3 patients of these survived to be discharged. Two patients who underwent pneumonectomy for multiple lung abscess and open drainage for liver abscess, were resuscitated but did survived. The Latter died from bleeding due to rupture of the liver that developed during the closed chest cardiac massage. One patient who had open chest cardiac massage survived to be discharged without any sequele. Unsuccessful resuscitation was observed in two patients, one had a complication of malignant hyperthermia with muscle rigidity during gastrectomy for ulcer perforation and another had not firm support on the back during massage.

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.1001-1006
• /
• 1995

From January, 1990 to December, 1994, we have operated 10 patients with cardiac rupture. The patients are divided into two groups according to their clinical manifestation ; five patients in each hemorrhage and tamponade group. The patients in both groups could maintain their vital signs with closed thoracostomy and fluid resuscitation. The effect of pericardiocentesis was especially dramatic in three patients of tamponade group. The average time from injury to admission was 101 minutes and that of the patients who came our hospital via one or two other hospitals was 170 minutes comparing 31 minutes of those who came directly. The average time from admission to operation was 211 minutes. Considering 98 minutes for the diagnosis and preoperative management and another 30 minutes for the preparation for operation, operations were delayed by 83 minutes to get permission. We conclude that this delaying time for transport and operation of heart-ruptured patients should be shortened in order to manage them more effectively.

• Journal of Trauma and Injury
• /
• v.28 no.2
• /
• pp.67-70
• /
• 2015

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.

• Journal of Chest Surgery
• /
• v.55 no.3
• /
• pp.239-242
• /
• 2022

Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.