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KMID : 0364020160490060435
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Korean Journal of Thoracic and Cardiovascular Surgery
2016 Volume.49 No. 6 p.435 ~ p.442
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Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years
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Yun Jeong-Hee
Byun Joung-Hun
Kim Sung-Hwan
Moon Sung-Ho
Park Hyun-Oh
Hwang Sang-Won
Kim Yong-Hwan
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Abstract
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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.
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KEYWORD
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Cardiac tamponade, Trauma, Rupture
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