- 1.The patient is stable. In this case the best access is median sternotomy, because:
It is less painful for the patient
The exposure for the heart and the great vessels is optimal
The disadvantage is that this approach provides limited access to other potentially injured structures, such as the lung, subclavian vessels, aorta, and intercostal vessels.
- 2.The patient is unstable. In this case the anterolateral thoracotomy offers several advantages:
It is faster
It can be made with basic instruments
It allows access to several structures besides the heart
Both techniques are described in Chap. 2.
Hemothorax if the wound on the pericardium is a big one
KeywordsCardiac trauma Cardiac repair
The sac is captured with a Kelly forceps and the incision is made with a scissor, avoiding the phrenic nerve (MP4 11666 kb)
Dacron prosthesis (MP4 5769 kb)
- Ferrada R. Trauma Cardíaco. Manejo Operatorio. Rev Col Cirugía 2001;16:5–15.Google Scholar