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Lee A, Hameed SM, Kaminsky M, Ball CG. Penetrating cardiac trauma. Surg Open Sci 2022; 11:45-55. [DOI: 10.1016/j.sopen.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
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Kaljusto ML, Tønnessen T. How to mend a broken heart: a major stab wound of the left ventricle. World J Emerg Surg 2012; 7:17. [PMID: 22640705 PMCID: PMC3467162 DOI: 10.1186/1749-7922-7-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 04/24/2012] [Indexed: 11/13/2022] Open
Abstract
A 28-year-old male admitted with a stab wound under his left nipple, underwent emergency surgery because of confusion, a decreasing blood pressure and increasing tachycardia. A median sternotomy incision was made and after establishing cardiopulmonary bypass, a 7 cm wound in the left ventricle and a smaller wound in the left atrium were repaired. An injured segment of lung was resected and the left anterior descending and circumflex arteries were grafted after weaning from cardiopulmonary bypass was initially unsuccessful. Although the patient suffered a stroke, probably due to prehospital hypoperfusion, he eventually recovered without major sequelae. In addition to the case report we present a literature review of the last 15 years pertaining the management of penetrating cardiac injury.
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Affiliation(s)
- Mari-Liis Kaljusto
- Department of Cardiothoracic Surgery, Oslo University Hospital, Ullevål PB 4956 Nydalen, and University of Oslo, Oslo, 0424, Norway.
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Atkins BZ, Salomone JP, Subramanian A, Burke JR, Vercruysse GA. Management of Traumatic Coronary Artery Injuries: Advantages of Off-Pump Coronary Artery Bypass. Eur J Trauma Emerg Surg 2009; 36:380-4. [PMID: 26816044 DOI: 10.1007/s00068-009-9063-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 07/21/2009] [Indexed: 11/25/2022]
Abstract
Coronary artery injuries are rare but highly lethal. Debate exists as to the best treatment for this complex set of injuries, with historical treatment favoring arterial ligation. Although conventional coronary artery bypass grafting using cardiopulmonary bypass has been used somewhat successfully, enthusiasm for off-pump CABG (OPCAB) has grown more recently. We report two unique cases of left anterior descending coronary arterial injuries managed successfully with OPCAB.
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Affiliation(s)
- B Zane Atkins
- Department of Surgery, Durham Veterans Affairs Medical Center, Surgical Services, Durham, NC, USA.
- Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD, USA.
- Department of Surgery, Durham Veterans Affairs Medical Center,Surgical Services 112, 508 Fulton Street, Durham, 27705, NC, USA.
| | - Jeffrey P Salomone
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | | | - J Ryan Burke
- Carolina Cardiac Surgery, Palmetto Health Richland Hospital, Columbia, SC, USA
| | - Gary A Vercruysse
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
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Bergsland J, Lingaas PS, Skulstad H, Hol PK, Halvorsen PS, Andersen R, Småstuen M, Lundblad R, Svennevig J, Andersen K, Fosse E. Intracoronary Shunt Prevents Ischemia in Off-Pump Coronary Artery Bypass Surgery. Ann Thorac Surg 2009; 87:54-60. [PMID: 19101268 DOI: 10.1016/j.athoracsur.2008.08.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 08/12/2008] [Accepted: 08/13/2008] [Indexed: 10/21/2022]
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Park K, Moon SW, Yoon JS, Jo KH, Wang YP, Lee WJ. Off-pump repair of LAD transection and LV rupture for cardiac stab wound. THE JOURNAL OF TRAUMA 2008; 64:E74-5. [PMID: 17413528 DOI: 10.1097/01.ta.0000224893.18493.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Kuhn Park
- Departments of Thoracic and Cardiovascular Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Moore FO, Berne JD, Turner WF, Villarreal DH, Mcgovern T, Rowe SA, Norwood SH. Off-Pump Coronary Artery Bypass is an Alternative to Conventional Cardiopulmonary Bypass When Repair of Traumatic Coronary Artery Injuries is Indicated. Am Surg 2007. [DOI: 10.1177/000313480707300323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coronary artery injuries after penetrating cardiac trauma are rare. The standard approach to these injuries has traditionally been coronary artery ligation. When cardiac perfusion is profoundly compromised, cardiopulmonary bypass has been used to facilitate revascularization, although with serious morbidity. We report a case of traumatic left anterior descending coronary artery transection repaired off-pump in a young stabbing victim. Penetrating traumatic cardiac injuries are highly lethal injuries. Cardiopulmonary bypass has been used for myocardial revascularization when cardiac perfusion is compromised, although with significant complications. Off-pump coronary artery bypass is a safe alternative in the traumatized patient.
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Affiliation(s)
- Forrest O. Moore
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
| | - John D. Berne
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
| | - William F. Turner
- Division of Cardiothoracic Surgery, East Texas Medical Center, Tyler, Texas
| | - David H. Villarreal
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
| | - Thomas Mcgovern
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
| | - Stephen A. Rowe
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
| | - Scott H. Norwood
- Division of Trauma and Surgical Critical Care, East Texas Medical Center, Tyler, Texas and
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Vasquez JC, Baciewicz FA. Late onset angina after penetrating cardiac injury adjacent to a coronary artery. THE JOURNAL OF TRAUMA 2006; 60:1344-6. [PMID: 16766982 DOI: 10.1097/01.ta.0000220366.67505.2f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Julio C Vasquez
- Division of Cardiothoracic Surgery, Harper University Hospital, Wayne State University, Detroit, Michigan 48201, USA
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Abstract
Damage control of thoracic injuries begins frequently with an emergency department thoracotomy via an anterolateral incision. Bleeding and air leaks are quickly temporised. As opposed to abdominal damage control where most injuries can be temporised, most thoracic injuries require initial definitive repair. Thus, the goal of thoracic damage control is to perform the least definitive repair using the fastest and easiest techniques to shorten the operative time as much as possible. There are some injuries that can be temporised and require re-operation once physiologic normality has been achieved.
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Affiliation(s)
- Michael F Rotondo
- School of Medicine, East Carolina University, 600 Moye Blvd. Greenville, NC 27858-4354, USA.
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Bowley DMG, Saeed M, Somwe D, Boffard KD, Naidoo K, Davis SC. Off-pump cardiac revascularization after a complex stab wound. Ann Thorac Surg 2002; 74:2192-3. [PMID: 12643425 DOI: 10.1016/s0003-4975(02)04106-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Penetrating cardiac injuries are among the most dramatic and lethal of all injuries. High survival rates in selected reports have given the erroneous impression that the lethality of cardiac injuries has diminished in recent years. In a review of 1,198 cases of penetrating cardiac trauma from South Africa, only 6% of patients arrived at hospital alive. Many patients with proximal coronary artery injuries present without signs of life. Cardiopulmonary bypass is advocated as a means of salvage, but mortality rates are high. We present a case of arterial revascularization using off-pump technology.
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Fedalen PA, Frank AM, Piacentino V, Fisher CA, Pathak AS, Furukawa S, Buckman RF. Off-pump extraction of an embedded high posterior left ventricular bullet utilizing a new cardiac stabilization device. THE JOURNAL OF TRAUMA 2001; 51:1011-3. [PMID: 11706356 DOI: 10.1097/00005373-200111000-00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- P A Fedalen
- Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
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