Introduction: Cardiac injuries are one of the important causes of death in young population. With aggressive resuscitative therapy and emergency room thoracotomy, the salvage rate of these patients can reach 35%. In t...Introduction: Cardiac injuries are one of the important causes of death in young population. With aggressive resuscitative therapy and emergency room thoracotomy, the salvage rate of these patients can reach 35%. In this case series the types of presentation, methods of resuscitation, surgical approaches, operative and postoperative outcomes are discussed. Patients and Methods: From January 2009 to January 2014 there were 3157 patients treated for thoracic injuries at Sulaimani university hospital, 14 patients had cardiac injuries. All admitted cases with central chest trauma were submitted to a thorough clinical examination, ECG and eFAST (extended Focused assessment with sonography for trauma) and/or transthoracic echocardiography. Results: Total of 14 cardiac injuries from 3157 causalities were identified, which is 0.44% of the total admissions. Male gender was predominant (85.7% vs. 14.28%) for females. Mechanism of injury was mostly penetrating (85.71%) among which stabs were majority (57.14%) while bullet and shrapnel each constituted (14.28%). Mean time of interval between the accident and our intervention was 2.96 hours. No diagnostic test was 100% specific and sensitive. Discussion: Cardiac injury regarded as a crucial injury because of its high fatality. It is reported that 10.3% of emergency surgical operations are thoracic type and about 1% of them are associated with cardiac injury. Although any penetrating injury to the thorax may injure the heart but those within the box are more suspicious. We conclude that cardiac trauma is a fatal injury but still if the facilities are available the mortality can be minimized.展开更多
Introduction: Patients presenting with cardiac injuries from gunshot wounds and blunt chest trauma have high mortality, without any observed survival benefit when presenting with cardiac tamponade. Cardiac tamponade i...Introduction: Patients presenting with cardiac injuries from gunshot wounds and blunt chest trauma have high mortality, without any observed survival benefit when presenting with cardiac tamponade. Cardiac tamponade is a life-threatening hemodynamically significant compression of the heart by a sudden or gradual accumulation of collections in the pericardial space that incites and overrides the body’s compensatory mechanism. Clinical Case: We present and discuss the successful management and survival of two patients with traumatic cardiac tamponade from gunshot wounds to the precordium who underwent successful lifesaving median sternotomy at a Teaching Hospital in Ghana with a new Cardiovascular and Thoracic Surgery Unit. Discussion: Usually the diagnosis of cardiac tamponade from traumatic haemopericardium is made by clinical findings which though may not always be present especially after blunt chest trauma. EFAST is a reliable tool for diagnosing and following cardiac tamponade. Median sternotomy is the standard procedure in these patients to access and repair cardiac injury either with or without cardiopulmonary bypass. Conclusion: Emergency median sternotomy in patients with cardiac tamponade from chest trauma especially after EFAST diagnosis can be lifesaving even in less resourced centres.展开更多
Data from the last 50 years suggest that pediatric pa-tients typically suffer cardiothoracic injuries following blunt traumatic force(70%) in the setting of either motor vehicle crashes(53.5%) or vehicle-pedestrian ac...Data from the last 50 years suggest that pediatric pa-tients typically suffer cardiothoracic injuries following blunt traumatic force(70%) in the setting of either motor vehicle crashes(53.5%) or vehicle-pedestrian accidents(18.2%). Penetrating trauma accounts for 30% of pediatric cardiothoracic injuries, half of which are gunshot wounds. Graduated driver licensing progr-ams, gun-control legislation, off-road vehicle regulation, initiatives such as "Prevent the Bleed", as well as prof-essional society recommendations are key in preventing pediatric cardiothoracic injuries.展开更多
文摘Introduction: Cardiac injuries are one of the important causes of death in young population. With aggressive resuscitative therapy and emergency room thoracotomy, the salvage rate of these patients can reach 35%. In this case series the types of presentation, methods of resuscitation, surgical approaches, operative and postoperative outcomes are discussed. Patients and Methods: From January 2009 to January 2014 there were 3157 patients treated for thoracic injuries at Sulaimani university hospital, 14 patients had cardiac injuries. All admitted cases with central chest trauma were submitted to a thorough clinical examination, ECG and eFAST (extended Focused assessment with sonography for trauma) and/or transthoracic echocardiography. Results: Total of 14 cardiac injuries from 3157 causalities were identified, which is 0.44% of the total admissions. Male gender was predominant (85.7% vs. 14.28%) for females. Mechanism of injury was mostly penetrating (85.71%) among which stabs were majority (57.14%) while bullet and shrapnel each constituted (14.28%). Mean time of interval between the accident and our intervention was 2.96 hours. No diagnostic test was 100% specific and sensitive. Discussion: Cardiac injury regarded as a crucial injury because of its high fatality. It is reported that 10.3% of emergency surgical operations are thoracic type and about 1% of them are associated with cardiac injury. Although any penetrating injury to the thorax may injure the heart but those within the box are more suspicious. We conclude that cardiac trauma is a fatal injury but still if the facilities are available the mortality can be minimized.
文摘Introduction: Patients presenting with cardiac injuries from gunshot wounds and blunt chest trauma have high mortality, without any observed survival benefit when presenting with cardiac tamponade. Cardiac tamponade is a life-threatening hemodynamically significant compression of the heart by a sudden or gradual accumulation of collections in the pericardial space that incites and overrides the body’s compensatory mechanism. Clinical Case: We present and discuss the successful management and survival of two patients with traumatic cardiac tamponade from gunshot wounds to the precordium who underwent successful lifesaving median sternotomy at a Teaching Hospital in Ghana with a new Cardiovascular and Thoracic Surgery Unit. Discussion: Usually the diagnosis of cardiac tamponade from traumatic haemopericardium is made by clinical findings which though may not always be present especially after blunt chest trauma. EFAST is a reliable tool for diagnosing and following cardiac tamponade. Median sternotomy is the standard procedure in these patients to access and repair cardiac injury either with or without cardiopulmonary bypass. Conclusion: Emergency median sternotomy in patients with cardiac tamponade from chest trauma especially after EFAST diagnosis can be lifesaving even in less resourced centres.
文摘Data from the last 50 years suggest that pediatric pa-tients typically suffer cardiothoracic injuries following blunt traumatic force(70%) in the setting of either motor vehicle crashes(53.5%) or vehicle-pedestrian accidents(18.2%). Penetrating trauma accounts for 30% of pediatric cardiothoracic injuries, half of which are gunshot wounds. Graduated driver licensing progr-ams, gun-control legislation, off-road vehicle regulation, initiatives such as "Prevent the Bleed", as well as prof-essional society recommendations are key in preventing pediatric cardiothoracic injuries.
