Choice of Incision in Penetrating Cardiac Injuries: Which one we must prefer? Thoracotomy or Sternotomy

Besir, Yuksel; Gokalp, Orhan; Eygi, Börteçin; İner, Hasan; Peker, Ihsan; Gökalp, Gamze; Yilik, Levent; Gürbüz, Ali

doi:10.5505/tjtes.2015.52882

Cited by 11 publications

(19 citation statements)

References 11 publications

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“…The localization of a heart injury can be different but most frequently it involves the right ventricle as it was the case with our patient [1].…”

Section: Resultsmentioning

confidence: 89%

“…We performed a full sternotomy and an open heart surgery with CPB. In the case of any anterior cardiac involvement without suspicion of pulmonary injury, the chosen technique is the median sternotomy [1], as it allows for a better view of frontal injuries [2]. One case reports a removed foreign body inside the heart by means of the left mini-anterolateral thoracotomy without CPB [3].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A Wire Located in the Heart - Case Report

Stadnik¹,

Baczewski²,

Stążka³

2017

J Clin Case Rep

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Chest injury penetrating to the heart occurs relatively rarely. The additional presence of a foreign body in the right ventricle is even more uncommon. Thus, we aim to present the case report of a wire located in the heart of a 29-year-old woman. A decision to perform a surgery was based on patient's examination, chest X-ray, and computed tomography (CT). The patient was discharged from the hospital seven days after the surgery, symptom-free.

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“…The localization of a heart injury can be different but most frequently it involves the right ventricle as it was the case with our patient [1].…”

Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

A Wire Located in the Heart - Case Report

Stadnik¹,

Baczewski²,

Stążka³

2017

J Clin Case Rep

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“…Por otra parte, las incisiones y los abordajes quirúrgicos varían entre las instituciones 25 . Las numerosas publicaciones acerca de los diversos manejos y abordajes de estas lesiones demuestran que no existe un consenso.…”

Section: Discussionunclassified

“…Las numerosas publicaciones acerca de los diversos manejos y abordajes de estas lesiones demuestran que no existe un consenso. Existen estudios que muestran tasas de supervivencia significativas en pacientes a quienes se realizó toracotomía anterolateral para lesiones cardiacas y que fueron admitidos al servicio de urgencias, mientras que otros argumentan que este tipo de abordaje solo debe ser realizado por equipos con la suficiente experiencia para obtener los mejores resultados 25 . Flaris, et al 26 subrayan que la incisión tipo clamshell es rápida y no causa pérdida de tiempo.…”

Section: Discussionunclassified

Incisión de Spangaro en lesiones cardiacas penetrantes, reporte de casos

Velázquez-Santiago¹,

Serna-Soto²,

Meza-López³

et al. 2020

CIRU

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Introducción: El trauma en México es un problema mayor de salud pública, siendo una de las principales causas de mortalidad en personas jóvenes. La incidencia reportada de trauma cardiaco varía. El sitio primario de lesión miocárdica es la pared libre del ventrículo derecho. Casos clínicos: Se reportan dos casos de pacientes lesionados con un instrumento punzocortante en el tórax, sufriendo lesión miocárdica que requirió tratamiento quirúrgico de urgencia. Discusión: Existen diversas incisiones del tórax. La elección dependerá de la situación a tratar, el estado hemodinámico y el número de lesiones. Ante una lesión cardiaca, el abordaje de Spangaro es una prudente elección.

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“…Initiation of CPB through this incision is much easier. It also enables in achieving access to all regions of the heart, including the right heart and both the pleuras (3,21) . Kaplan et al used median sternotomy as an initial incision in 28.57% of patients and Kaljusto et al used it in 35% of patients (10,13) .…”

Section: Discussionmentioning

confidence: 99%

Our Surgical Management Strategy for Cardiac Injury

Atay¹,

Bakuy²,

Saydam³

et al. 2017

Kosuyolu Heart Journal

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patients diagnosed with cardiac injury were retrospectively evaluated. Patients were evaluated according to the demographics, mean time from admission to surgery, concurrent interventions, type and localization of cardiac injury, and preoperative mean arterial blood pressure. Results:Eight patients who suffered from cardiac arrest underwent emergency surgery by thoracotomy. On admission to emergency service (ES), 22 patients were in shock. In ES, because the hemodynamic situation of six patients worsened despite fluid therapy, they underwent surgery without performing additional tests or imaging. The localization of the injuries were the right ventricle in 19 patients, left ventricle in 15 patients, right atrium in 2 patients, and both the right and left ventricles in 1 patient. In 34 patients, the primary suturing technique was sufficient for repair but two patients were operated on using cardiopulmonary bypass. The mean time from admission to surgery was 3.16 ± 2.37 h. The mean duration of intensive care unit stay was 2.37 ± 2.1 days. On an average, 5.16 ± 4.21 units of packed erythrocyte suspension were transfused. The mortality rate was 37.83% (n= 14). Conclusion:Improvements in emergency interventions, transportation, and availability of echocardiography in the emergency departments have to be more appropriate and efficient for better outcome in the new series. Bulgular: Sekiz hasta acil serviste kardiyopulmoner resüsitasyon eşliğinde acil torakotomi ile ameliyata alın-dı. Yirmi iki hastada şok tablosu mevcuttu. Altı hasta sıvı tedavisine rağmen tabloda kötüleşme olması dolayı-sıyla ek tetkik beklenmeden operasyona alındı. Diğer hastalarda ise ekokardiyografi ve bilgisayarlı tomografi sonucunda kardiyak yaralanma olduğu saptanarak operasyona alındı. On dokuz hastada yaralanma sağ ventrikülde, 15 hastada sol ventrikülde, 1 hastada sağ ve sol ventrikülde, 2 hastada ise sağ atriyumdaydı. Otuz dört hastada yaralanmalar primer olarak süturasyon ile onarıldı. Bir hastada mitral kapak replasmanı, 2 hastada ise onarım kardiyopulmoner baypas altında yapıldı. Bir hastada sol internal mammarian arter yaralanması, 2 hastada femoral arter yaralanması ve 1 hastada ise vena kava inferior yaralanması vardı. Beş hastada mide ve ince bağırsak yaralanmaları olduğu için genel cerrahi ile operasyona devam edildi. Hastaların ortalama ameliyata alınma süresi 3.16 ± 2.37 saat olarak bulundu. Ortalama yoğun bakım ünitesinde yatış 2.37 ± 2.1 gün olarak hesaplandı. Hastalarda ortalama olarak 5.6 ± 4.21 ünite eritrosit süspansiyonu kullanıldı. Hastane mortalitesi 14 hasta ile %37.83 idi. Sonuç:Hastane öncesi acil müdahale ve transport imkanlarının gelişmesi, ekokardiyografinin acil servislerde ulaşılabilirliğinin artmasıyla kalp yaralanmalarının daha yüz güldürücü sonuçlarla yeni serilerde karşımıza çıkacağını umut ediyoruz.

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Choice of Incision in Penetrating Cardiac Injuries: Which one we must prefer? Thoracotomy or Sternotomy

Cited by 11 publications

References 11 publications

A Wire Located in the Heart - Case Report

A Wire Located in the Heart - Case Report

Incisión de Spangaro en lesiones cardiacas penetrantes, reporte de casos

Our Surgical Management Strategy for Cardiac Injury

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