Korean J Thorac Cardiovasc Surg.  2016 Dec;49(6):435-442. 10.5090/kjtcs.2016.49.6.435.

Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years

• Yun JH
• Byun JH
• Kim SH
• Moon SH
• Park HO
• Hwang SW
• Kim YH

• KMID: 2362161
• DOI: http://doi.org/10.5090/kjtcs.2016.49.6.435

Abstract

BACKGROUND
Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture.
METHODS
This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities.
RESULTS
Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p= 0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived.
CONCLUSION
We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.

Keyword

Cardiac tamponade; Trauma; Rupture

MeSH Terms

Accidents, Traffic
Cardiac Tamponade
Creatine
Glasgow Coma Scale
Heart Atria
Heart Injuries*
Heart Rupture
Humans
Injury Severity Score
Mortality
Platelet Count
Retrospective Studies
Rupture
Survivors
Creatine