Evaluación y tratamiento de los traumatismos cardíacos

Echevarría, José Ramón Llanes; Román, Alberto San

doi:10.1016/s0300-8932(00)75146-3

Cited by 18 publications

(11 citation statements)

References 89 publications

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“…In a review of patients with combined trauma, a diagnostic transdiaphragmatic pericardiothomy was performed selectively in patients in whom the laparothomy was the first intervention, like our patient [8,9]. Ultrasonography could have been an important diagnostic tool in the emergency department for the assessment of abdominal injury and the diagnosis of haemopericardium, in the presence of which, an anterior thoracothomy must take priority [10,8,11].…”

Section: Discussionmentioning

confidence: 94%

Massive pulmonary embolism and cardiac arrest complicating a stab wound to the heart

Valderrey¹,

Ojo²,

López³

et al. 2011

Injury Extra

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Section: Discussionmentioning

confidence: 94%

Massive pulmonary embolism and cardiac arrest complicating a stab wound to the heart

Valderrey¹,

Ojo²,

López³

et al. 2011

Injury Extra

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“…El TPC afecta principalmente a hombres jóvenes previamente sanos, secundario a una herida por arma blanca o arma de fuego, pero también por causas iatrogénicas como cateterización de cavidades, instalación de drenajes torácicos, entre otros 3,4 . De acuerdo al tipo de agente traumático y mecanismo se pueden producir diferentes lesiones cardiacas, desde desgarros de la pared libre y lesiones de grandes vasos intrapericárdicos hasta lesiones coronarias o intracavitarias afectando septum, válvulas o incluso alteraciones del sistema de conducción 3 .…”

Section: Introductionunclassified

“…Pese a esto, se ha descrito que el TPC puede ir desde un cuadro totalmente asintomático hasta shock o colapso cardiovascular, por lo que su diagnóstico se basa en la clínica más el antecedente de un traumatismo torácico generalmente precordial. El taponamiento cardiaco es la forma más frecuente de presentación 3,4 . Se han descrito variables que se asocian a un peor pronóstico.…”

Section: Introductionunclassified

Traumatismo penetrante cardiaco: caracterización, resultados inmediatos y variables asociadas a morbilidad y mortalidad en pacientes operados

González

Riquelme²,

Fuentes³

et al. 2019

Rev. cir.

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Penetrating cardiac trauma: findings, outcomes and prognostic factors in operated patients Introduction: Penetrating cardiac trauma (PCT) constitute a permanent surgical challenge due to it characteristics and high mortality. Aim: To describe the findings, outcomes and prognostic factors in PCT. Materials and Method: Cross-sectional descriptive study, review of prospective thoracic trauma protocols and surgical registries. Period January 1990-December 2017. All patients with PCT were included. Various variables are described and analyzed. Univariate and multivariate analysis were performed to identify factors associated with morbidity, neurologic dysfunction and mortality. Results: 220 patients PCT, 209 (95.0%) men, mean age 30.4 ± 13.3, median 27 years. Mechanism: Aggression in 202 (91.8%). The traumatic agent was cold steel in 186 (84.4%) and fire arm in 21 (9.5%). 169 (76.8%) patients presented with tamponade, 103 (46.8%) shock and 20 (9.1%) cardiopulmonary arrest. Approach was sternotomy in 157 (71.4%), left thoracotomy in 58 (26.4%). The most common injured areas were right ventricle in 110 (50.0%), left ventricle in 72 (32.7%). 135 (61.4%) patients needed postoperative ICU and 74 (33.6%) were transfused. Complications occurred in 60 (27.3%). Twenty-one (9.5%) were reoperated. Mortality 28 (12.7%). The postoperative median stay was 6 days (Range 1-150). Prognostic factors were identified. Discussion: Operated PCT are more frequent in men with stab wound, the most common injured area is the right ventricle. The morbidity and mortality is comparable with international series.

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“…In recent years, due to the improvement of security mechanisms in cars, the frequency of cardiac injuries has decreased. However, there has been a rise of cardiac injuries caused by knives and firearms [2]. …”

mentioning

confidence: 99%

“…In extremely urgent situations, a left anterolateral thoracotomy is recommended, as it allows very fast and direct access to the heart [2]. …”

mentioning

confidence: 99%

Transmediastinal and Transcardiac Gunshot Wound with Hemodynamic Stability

Obrador

Al-Lal

Palacios

et al. 2014

Case Reports in Surgery

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Cardiac injuries caused by knives and firearms are slightly increasing in our environment. We report the case of a 43-year-old male patient with a transmediastinal gunshot wound (TGSW) and a through-and-through cardiac wound who was hemodynamically stable upon his admission. He had an entrance wound below the left clavicle, with no exit wound, and decreased breath sounds in the right hemithorax. Chest X-ray showed the bullet in the right hemithorax and large right hemothorax. The ultrasound revealed pericardial effusion, and a chest tube produced 1500 cc. of blood, but he remained hemodynamically stable. Considering these findings, a median sternotomy was carried out, the through-and-through cardiac wounds were suture-repaired, lung laceration was sutured, and a pacemaker was placed in the right ventricle. The patient had uneventful recovery and was discharged home on the twelfth postoperative day. The management and prognosis of these patients are determined by the hemodynamic situation upon arrival to the Emergency Department (ED), as well as a prompt surgical repair if needed. Patients with a TGSW have been divided into three groups according to the SBP: group I, with SBP >100 mmHg; group II, with SBP 60–100 mmHg; and group III, with SBP <60 mmHg. The diagnostic workup and management should be tailored accordingly, and several series have confirmed high chances of success with conservative management when these patients are hemodynamically stable.

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Evaluación y tratamiento de los traumatismos cardíacos

Cited by 18 publications

References 89 publications

Massive pulmonary embolism and cardiac arrest complicating a stab wound to the heart

Massive pulmonary embolism and cardiac arrest complicating a stab wound to the heart

Traumatismo penetrante cardiaco: caracterización, resultados inmediatos y variables asociadas a morbilidad y mortalidad en pacientes operados

Transmediastinal and Transcardiac Gunshot Wound with Hemodynamic Stability

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