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Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years

  • Yun, Jeong Hee (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Byun, Joung Hun (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine) ;
  • Kim, Sung Hwan (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine) ;
  • Moon, Sung Ho (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine) ;
  • Park, Hyun Oh (Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine) ;
  • Hwang, Sang Won (Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Yong Hwan (Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2016.03.24
  • 심사 : 2016.08.26
  • 발행 : 2016.12.05

초록

Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p=0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.

키워드

참고문헌

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피인용 문헌

  1. Isolated right atrial rupture from blunt trauma: a case report with systematic review of a lethal injury vol.14, pp.None, 2016, https://doi.org/10.1186/s13019-019-0836-8
  2. Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs vol.52, pp.5, 2019, https://doi.org/10.5090/kjtcs.2019.52.5.372
  3. “I Tripped and Broke My Heart”: A Case Report of Right Atrial Rupture vol.2, pp.2, 2016, https://doi.org/10.1016/j.cjco.2020.01.001