1/29. Traumatic coronary-pulmonary artery fistula, 23 years after a stab wound.We describe a 50-year-old man with onset of severe hemoptysis and anemia. Twenty-three years earlier, he had undergone a surgical procedure for a left thoracic wound as a result of a knife injury. Current diagnosis of aneurysm of the left ventricle and coronary-pulmonary artery fistula was made after coronary arteriography. The patient underwent resection of the aneurysm and repair of the fistula.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/29. The management of stab wounds to the heart with laceration of the left anterior descending coronary artery.Penetrating cardiac injuries are an increasing cause of traumatic deaths in urban areas. The management of these injuries has undergone a transition from simple pericardiocentesis to cardiac ultrasound evaluation in the stable patient, and emergency thoracotomy and repair of myocardial wounds in the unstable patient in extremes. The incidence of traumatic coronary artery injury is not accurately known because not all victims are examined. With the improvement in emergency medical services, including speed of transportation of these patients, better resuscitation, and knowledgeable use of cardiac ultrasound or emergency room thoracotomy, more patients with coronary artery injuries will survive and reach the operating room. The operative management of the injured coronary artery is dependant on the location of the injury and whether there is myocardial dysfunction. Distal injuries with small myocardial infarction should be treated by ligation alone. Proximal injury and those injuries associate with larger area of ischaemia or infarction are best treated with coronary artery bypass. The role of cardiopulmonary bypass pump in these patients should be evaluated depending on the homodynamic stability of the patient. We present two cases of cardiac stab wounds with transection of the left anterior descending (LAD), which were successfully managed. A literature review regarding the management of combined cardiac and coronary artery injuries is also provided.- - - - - - - - - - ranking = 1.5keywords = coronary (Clic here for more details about this article) |
3/29. Delayed cardiac tamponade after coronary artery laceration.Delayed cardiac tamponade after laceration of a coronary artery is unusual and uncommonly reported in the literature. We describe a patient in whom this potentially fatal complication developed 8 days after a stab wound to his chest. In our review of the English language literature we identified only one other report of delayed tamponade after coronary artery laceration.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
4/29. Off-pump cardiac revascularization after a complex stab wound.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.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
5/29. Penetrating injury of the chest and coronary arteriovenous fistula.An unusual case of coronary artery fistula, due to a stab wound in the chest in a 17-year-old male patient, with a resultant acute inferior myocardial infarction is presented. At surgery, complete transection of the right coronary artery was found, which formed a fistulous communication with both the right atrium and the right ventricle. The development of a continuous murmur in the period immediately after the injury, the absence of hemopericardium, and multiple cardiac-chamber involvements were unique features of the case. The inferior myocardial wall was akinetic due to infarction and did not improve following revascularization surgery. A brief review of the literature is also presented.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
6/29. Endovascular repair of accidental ligation of the right coronary artery during cardiorrhaphy for penetrating heart wound.We report a patient with a cardiac penetrating wound who underwent cardiorrhaphy which resulted in accidental ligation of the proximal right coronary artery (RCA), producing a postoperative acute inferior wall myocardial infarction. Although the option of surgical relief of the suture over the RCA was discussed, a repeat operation was considered to be of very high risk. Therefore, an endovascular attempt to recanalize the vessel was chosen. The external constriction around the RCA was successfully relieved with percutaneous transluminal coronary angioplasty (PTCA) and stenting. To our knowledge, this particular situation has not yet previously been published.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
7/29. Case report: the management of penetrating cardiac trauma with major coronary artery injury--is cardiopulmonary bypass essential?Major coronary artery injury in penetrating cardiac trauma is relatively uncommon and is associated with a poor prognosis. However, for a variety of reasons, the outcome for such patients has been improving during the last two decades. The main factor responsible for this change is, according to some authors, the use of emergency cardiopulmonary bypass (CPB). We present a case of complete transection of the LAD coronary artery managed by primary ligation of the vessel, but because of progressive signs of extensive myocardial infarction, the patient underwent emergency CPB and an aortocoronary bypass graft. The patient experienced a good cardiac recovery but died 5 days later of irreversible anoxic brain damage. In reviewing the literature concerning the absolute need for emergency CPB in the management of penetrating coronary artery injury (PCAI), we found that the overall outcome for patients treated with emergency CPB was not significantly better than for those treated with ligation alone. We believe that CPB is not always essential in the management of PCAI and should be instituted only when the injury to a main coronary artery is very proximal, whenever associated intracardiac injuries exist, or when the patient develops extensive myocardial infarction or uncontrolled arrhythmias following ligation of the injured coronary vessel.- - - - - - - - - - ranking = 1.6666666666667keywords = coronary (Clic here for more details about this article) |
8/29. Repair of stab-wound laceration of the aortic arch using deep hypothermia and circulatory arrest.The surgical management of a 56-year-old patient with a single thoracic stab wound penetrating the left innominate vein and the aortic arch is described. Repair was successfully achieved using extracorporal circulation and circulatory arrest during deep hypothermia. Clinical features and surgical approach are described and discussed in detail.- - - - - - - - - - ranking = 0.025900224705063keywords = circulation (Clic here for more details about this article) |
9/29. Intra-aortic balloon counterpulsation in penetrating cardiac trauma.A case is presented in which the intra-aortic balloon pump (IABP) was used to successfully manage cardiogenic shock in a patient with a cardiac stab wound, not involving a coronary artery.- - - - - - - - - - ranking = 0.16666666666667keywords = coronary (Clic here for more details about this article) |
10/29. Chest stab wound-related coronary artery pseudoaneurysm sealed with a polytetrafluoroethylene-covered stent.We describe a case in which a polytetrafluoroethylene (PTFE)-covered stent was implanted to treat impending rupture of a coronary artery pseudoaneurysm related to a chest stab wound. In this case, transthoracic echocardiography was used to verify the characteristics of the pseudoaneurysm, and we concluded that a PTFE-covered stent may prevent rupture in post-traumatic pseudoaneurysm.- - - - - - - - - - ranking = 0.83333333333333keywords = coronary (Clic here for more details about this article) |
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