Surgical repair of right atrial wall rupture after blunt chest trauma.

Abstract

Right atrial wall rupture after blunt chest trauma is a catastrophic event associated with high mortality rates. We report the case of a 24-year-old woman who was ejected 40 feet during a motor vehicle accident. Upon presentation, she was awake and alert, with a systolic blood pressure of 100 mmHg. Chest computed tomography disclosed a large pericardial effusion; transthoracic echocardiography confirmed this finding and also found right ventricular diastolic collapse. A diagnosis of cardiac tamponade with probable cardiac injury was made; the patient was taken to the operating room, where median sternotomy revealed a 1-cm laceration of the right atrial appendage. This lesion was directly repaired with 4-0 polypropylene suture. Her postoperative course was uneventful, and she continued to recover from injuries to the musculoskeletal system. This case highlights the need for a high degree of suspicion of cardiac injuries after blunt chest trauma. An algorithm is proposed for rapid recognition, diagnosis, and treatment of these lesions.

• Authors: Jose E Telich-Tarriba, Javier E Anaya-Ayala, Michael J Reardon
• Journal: Texas Heart Institute journal (Tex Heart Inst J) Vol. 39 Issue 4 Pg. 579-81 ( 2012) ISSN: 1526-6702 [Electronic] United States
• PMID: 22949784 (Publication Type: Case Reports, Journal Article)

Topics

• Accidents, Traffic
• Algorithms
• Atrial Appendage (injuries, surgery)
• Cardiac Surgical Procedures
• Cardiac Tamponade (etiology, surgery)
• Echocardiography
• Female
• Heart Injuries (diagnosis, etiology, physiopathology, surgery)
• Hemodynamics
• Humans
• Pericardial Effusion (etiology, surgery)
• Sternotomy
• Suture Techniques
• Tomography, X-Ray Computed
• Treatment Outcome
• Wounds, Nonpenetrating (diagnosis, etiology, physiopathology, surgery)
• Young Adult