[Resuscitative transverse thoracotomy].
The technique of resuscitative transverse thoracotomy is for use in case of circulatory arrest in the trauma patient. This technique, performed after orotracheal intubation, is initiated by a 5th intercostal space thoracostomy in each mid-axillary line. If the circulatory arrest is not caused by a tension pneumothorax, bilateral thoracotomies in the 5th intercostal spaces with transverse transsection of the sternum is performed. Middle vertical incision of the pericardium allows the evacuation of a cardiac tamponade. This wide surgical access has proved simple to perform, even by non experienced operators. It allows digital control of a heart wound, cross-clamping of the thoracic descending aorta or of pulmonary hilum, rapid perfusion of warm fluids through the right auricle and the performance of bimanual internal cardiac massage.
Voiglio
E J
EJ
Service de chirurgie d'urgence, centre hospitalier Lyon-Sud, université Lyon I, F96495 Pierre-Bénite, France. eric.voiglio@adm.univ-lyon1.fr
Coats
T J
TJ
Baudoin
Y P
YP
Davies
G D
GD
Wilson
A W
AW
D006323:Heart Arrest / Q000601:surgery*; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D013898:Thoracic Injuries / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods*