title: Nonoperative management of blunt traumatic cardiac rupture: considerations of a novel approach.
abstract: Blunt traumatic cardiac rupture carries a dismal prognosis. Patients who survive to presentation are treated with prompt surgical repair. Operative intervention carries significant morbidity and mortality, as these patients present in extremis. Intervention can be complicated by prior cardiac surgery. Obliteration of the pericardial space from adhesions may offer the patient an alternative conservative option under rare circumstances. We present a case of an older man with blunt cardiac rupture caused by a motor vehicle crash. The patient remained hemodynamically stable as his rupture only communicated with a small space within his obliterated pericardial sac. He was managed nonoperatively.
authors.affiliation: Department of Surgery, Division of Acute Care Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pucci
authors.forename: Charles
authors.initials: C
authors.lastname: Warrington
authors.forename: Gary A
authors.initials: GA
authors.lastname: Lindenbaum
authors.forename: Kris R
authors.initials: KR
authors.lastname: Kaulback
authors.forename: Jay S
authors.initials: JS
authors.lastname: Jenoff
authors.forename: Niels D
authors.initials: ND
authors.lastname: Martin
mesh_terms: D000063:Accidents, Traffic; D000369:Aged, 80 and over; D004452:Echocardiography; D004750:Enteral Nutrition / Q000379:methods*; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D020127:Recovery of Function; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D014665:Vasodilator Agents / Q000627:therapeutic use; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000628:therapy*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate