Post-trauma “abrasive” right ventricular rupture without mediastinitis early post-CABG. Is the Robicsek closure technique necessary for all elderly patients?

Abstract

INTRODUCTIONRight ventricular (RV) rupture with mediastinitis, is a very rare but extremely dangerous (even fatal) complication, following CABG surgery.PRESENTATION OF CASEIn this paper, we present the case of a post-trauma (after fall) RV rupture (without mediastinitis) in a patient who had undergone cardiac surgery several days ago. The cause of the rupture proved to be a broken bone piece from the lower sternal edge.DISCUSSIONRV rupture post-operatively caused by broken bone pieces or bone dislocation may occur through two mechanisms: either penetration of the RV, or through the “sandpaper effect”. In order to prevent the rupture, we should be able to recognize patients with aggravating factors (age, weight) and choose intra-operatively a suitable closure technique.CONCLUSIONWe propose that the technique that could prevent such ruptures is the Robicsek technique.

Cardiac ventricular tear following blunt chest trauma

“…Age and body weight prove to be aggravating factors [6]. Elderly patients are more prone to osteoporosis or lower bone density, making bone fractures easy to occur and difficult to mend [7].…”