Kyobu geka. The Japanese journal of thoracic surgery
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Case Reports
[Acute left ventricular rupture and cardiac tamponade caused by blunt trauma; report of a case].
It is difficult to save patients with acute left ventricular rupture and cardiac tamponade caused by blunt trauma. A 67-year-old man hospitalized due to sustained multiple blunt trauma. The systolic blood pressure was 40 mmHg. ⋯ After complete digital compression, the portion was covered by a biological tissue adhesive/sealant sheet (TachoComb), which completely suppressed bleeding. The postoperative course was uneventful. He was discharged from the hospital on the 20th day after the operation.
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A 52-year-old woman, who had attempted to commit suicide with a kitchen knife, was admitted. Upon arrival, conscious level was II-30 and blood pressure was 76/46 mmHg. The knife with a blade 20 cm long penetrated the thorax from the 7th left intercostal space beside sternum toward the heart and synchronously moved with pulsation of the heart. ⋯ The wound of the right ventricle was closed with reinforced using felt-strips. The postoperative course was uneventful. This case suggested that the most important factor for survival in cardiac trauma would be to make the hemodynamics stable with the urgent treatment just after arrival and to perform the surgical repair immediately.