[Acute left ventricular rupture and cardiac tamponade caused by blunt trauma; report of a case].
It is difficult to save patients with acute left ventricular rupture and cardiac tamponade caused by blunt trauma. A 67-year-old man hospitalized due to sustained multiple blunt trauma. The systolic blood pressure was 40 mmHg. Chest computed tomography (CT) and ultrasonic echocardiography revealed cardiac tamponade. Abdominal CT indicated left renal contusion. Pericardial drainage via the subxiphoid approach drew about 1,000 ml of blood from the pericardial sac, which only transiently increased blood pressure. Median sternotomy and subsequent pericardiotomy revealed pulsatile bleeding jet through a laceration of about 2.0 cm long in the left ventricle near the first diagonal branch. After complete digital compression, the portion was covered by a biological tissue adhesive/sealant sheet (TachoComb), which completely suppressed bleeding. The postoperative course was uneventful. He was discharged from the hospital on the 20th day after the operation.
Nagahama
H
H
Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan.
Fukushima
Y
Y
Fukuda
T
T
Hayase
T
T
Yoshioka
M
M
D000208:Acute Disease; D000368:Aged; D002305:Cardiac Tamponade / Q000209:etiology* / Q000601:surgery; D006335:Heart Injuries / Q000209:etiology* / Q000601:surgery; D006352:Heart Ventricles / Q000293:injuries / Q000601:surgery; D006801:Humans; D008297:Male; D014949:Wounds, Nonpenetrating / Q000150:complications*