Posttraumatic and postoperative cardiac luxation: computed tomography findings in nine patients.
BACKGROUND
Posttraumatic and postoperative cardiac luxation represents a serious complication of pericardial rupture, and early diagnosis is important. The purpose of this study is to determine signs of left cardiac luxation on computed tomography (CT).


METHODS
CT scans in nine patients with pericardial rupture and cardiac luxation after blunt chest trauma (n = 7) and postoperatively after extended left pneumectomy (n = 2) were reviewed for abnormalities. We analyzed the clinical history, clinical findings, and the imaging findings.


RESULTS
Dislocation of the heart to the left and pneumopericardium were seen in nine patients. Five of these nine patients revealed "entrapment" of the left heart between the proximal ascending aorta and the descending aorta. All patients underwent a pneumopericardium. All patients with a history of trauma showed a left-sided pneumothorax but no pericardial effusion.


CONCLUSIONS
CT plays a key role for early diagnosis of cardiac luxation. Dislodgment of the heart, entrapment of the left atrium and ventricle, and pneumopericardium associated with pneumothorax are the most important CT findings.
Leibecke
Thorsten
T
Department of Radiology, Klinikum Neustadt, Holstein, Germany. tleibecke@schoen-kliniken.de
Stoeckelhuber
Beate Maria
BM
Gellissen
Joerg
J
Bartels
Claus
C
Meier
Torsten
T
Eberhardt
Frank
F
Helmberger
Thomas
T
Rademaker
Juergen
J
D000328:Adult; D003937:Diagnosis, Differential; D006335:Heart Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*