Cases reported "Heart Injuries"

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11/624. Successful repair of blunt cardiac rupture involving both ventricles.

    Blunt cardiac rupture occurs infrequently and is usually lethal. Successful repairs of isolated atrial or ventricular ruptures have been reported when the diagnosis is made early. Our patient sustained blunt cardiac rupture of both ventricles in a motor vehicle accident. The diagnosis was made during emergency exploratory laparotomy when her vital signs deteriorated without obvious cause. A large Satinsky clamp was placed across the apices of the right and left ventricle to control hemorrhage while the repair was done without cardiopulmonary bypass. She survived and was discharged to home with a normal echocardiogram. ( info)

12/624. Blunt cardiac rupture: the utility of emergency department ultrasound.

    BACKGROUND: rupture of the heart is usually a fatal injury in patients sustaining blunt trauma. Those arriving in the emergency department alive can be saved with prompt diagnosis and treatment. methods: We describe the cases of 4 consecutive patients with rupture of the free cardiac wall whom we treated at Grady Hospital. Two had a tear of the right ventricle, 1 had a tear of the right atrium, and 1 had two tears of the left atrium. All patients were involved in motor vehicle accidents. The diagnosis was made by ultrasound in 3 patients and during exploratory surgical intervention in the other. All tears were repaired primarily without the aid of cardiopulmonary bypass. RESULTS: Three of the patients survived, and 1 died. CONCLUSIONS: Rarely are patients with rupture of the free cardiac wall seen in an emergency department. The improvements in the prehospital care and the transportation may result in an increase in the numbers of such patients. physicians treating patients with blunt trauma must suspect the presence of cardiac rupture. Immediate use of ultrasonography will establish the diagnosis and prompt repair of the injury may improve overall survival. ( info)

13/624. commotio cordis: sudden cardiac death in athletes.

    commotio cordis due to blunt trauma to the precordium is a rare cause of death in young athletes, occurring less frequently than all of the other athletics-related deaths. Several measures, such as the use of safety baseballs and the use of chest protectors, can help protect young athletes from commotio cordis. In general, sudden cardiac death in athletes is receiving increasing attention from the public as a result of recent deaths of high-profile athletes. Sudden cardiac death, however, is rare, with an estimated 1 out of 200,000 high school athletes at risk each year. However, the personal, physiological, and cardiovascular benefits of athletics far outweigh the risks. Therefore, the message to parents is to allow their children to participate in athletics because the benefits far outweigh the risks. ( info)

14/624. Septal branch right ventricular fistula: a complication in coronary artery snaring.

    We report a septal branch right ventricular fistula complicated after coronary snaring in coronary artery bypass surgery without aortic cross-clamping. The tip of the needle of the snaring suture is made blunt in order to decrease the risk of mechanical injury, but trauma to the septal branch is possible. This rare complication of snaring should be taken into consideration in performing aortic nonclamping coronary artery bypass surgery. ( info)

15/624. Cardiac injury from an air gun pellet: a case report.

    air guns are tools which each day become more powerful serious or even fatal accidents are caused by them. We report the clinical case of a 10-year old patient who received an accidental shot puncturing the right auricle, with generation of an important hemopericardium. A favorable evolution followed conservative treatment. However, we want to emphasize the potential gravity of injuries caused by this type of weapon. ( info)

16/624. Right ventricular rupture during closed-chest cardiopulmonary resuscitation after pneumonectomy with pericardiotomy: a case report.

    SETTING: The collapse of a patient immediately after right pneumonectomy with right pericardiotomy resulted in closed-chest cardiopulmonary resuscitation, subsequent thoracotomy, and demise secondary to right ventricular rupture. Interventions: Closed-chest resuscitation with opened and closed chest tubes and medical and fluid interventions were inadequate, necessitating subsequent thoracotomy. MAIN RESULTS AND CONCLUSIONS: Right ventricular rupture during resuscitation was found during subsequent thoracotomy. This rupture and inadequacy of closed-chest resuscitation were felt to be associated with the operative pneumonectomy and pericardiotomy. Pathophysiology and the role of open-heart vs. closed-chest resuscitative measures are discussed. ( info)

17/624. Perforation of the right ventricular free wall by an active fixation transvenous cardioverter defibrillator lead.

    A 58-year-old patient with dilated cardiomyopathy underwent implantable cardioverter defibrillator (ICD) implantation. The postoperative course was complicated by perforation of the right ventricular free wall by the active fixation transvenous ICD lead. The type of ICD lead and the type of organic heart disease are apparently important risk factors for perforation. ( info)

18/624. Percutaneous closure of a left ventricular perforation post balloon mitral valvotomy.

    The risk of left ventricular perforation is a rare but well-recognized complication of percutaneous double balloon mitral valvuloplasty that usually requires surgical bailout. We describe a case of left ventricular perforation with cardiac tamponade, caused by the propulsion of the balloons during balloon mitral valvotomy on an 86-year-old female with previous thoracotomies that was resolved using percutaneous coil embolization of the perforation. This approach to these types of complications, although unlikely to be of extensive use, will serve to expand the horizon of options in the field of interventions. Cathet. Cardiovasc. Intervent. 48:78-83, 1999. ( info)

19/624. Indwelling catheter-induced right ventricular rupture.

    We describe a case of a 68-year-old man who, because of postoperative mediastinitis, underwent a multiple muscle flap closure of the mediastinum. A chronic indwelling catheter led to erosion and rupture of the anterior wall of the right ventricle. The near exsanguinating hemorrhage was corrected under circulatory arrest. A pericardial patch repair was performed with good results. ( info)

20/624. Blunt chest trauma and the heart.

    The Green Lane Hospital experience of patients presenting with cardiac damage as a result of chest trauma has been reviewed following the recent referral of a patient with tricuspid regurgitation due to trauma. A retrospective search of surgical records was made over the preceding 28 years which yielded a further nine patients. Our group has experienced a number of unusual causes of non-fatal cardiac trauma that have followed accidents. In nine out of ten cases closed chest injury resulted in damage to the heart. In some, diagnosis had been delayed for years. echocardiography is a very useful diagnostic tool. Surgery was undertaken in all cases. ( info)
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