Abstract
In cardiac trauma there are two basic scenarios:
-
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.
Once the chest has been opened, the surgeon may find:
-
Cardiac tamponade
-
Hemothorax if the wound on the pericardium is a big one
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Aida H, Kagaya S. Experience of surgical repair for cardiac trauma [Japanese]. Kyobu Geka. 2018;71(9):643–7.
Chestovich PJ, McNicoll CF, Fraser DR, Patel PP, Kuhls DA, Clark E, et al. Selective use of pericardial window and drainage as sole treatment for hemopericardium from penetrating chest trauma. Trauma Surg Acute Care Open. 2018;30;3(1):e000187.
Einberg M, Saar S, Seljanko A, Lomp A, Lepner U, Talving P. Cardiac injuries at estonian major trauma facilities: a 23-year perspective. 2018:1457496918783726. https://doi.org/10.1177/1457496918783726. [Epub ahead of print].
Ferrada R. Trauma Cardíaco. Manejo Operatorio. Rev Col Cirugía 2001;16:5–15.
Šimek M, Konečný J, Hájek R, Čižmář I, Kutěj V, Lonský V. Penetrating injuries of the heart and great vessels: fifteen years of experience of the cardiac surgery service as a part of the major trauma centre [Czech]. Acta Chir Orthop Traumatol Cech. 2018;85(2):144–8.
Vlček M, Jaganjac E, Niedoba M, Landor I, Neumann J. Current treatment procedures for civilian gunshot wounds. Rozhl Chir. 2018;97(12):558–62.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Electronic Supplementary Material
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)
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Ferrada, R. (2020). Cardiac Penetrating Trauma. In: Ferrada, P., Ferrada, R. (eds) Atlas of Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-26871-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-26871-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-26870-1
Online ISBN: 978-3-030-26871-8
eBook Packages: MedicineMedicine (R0)