Right atrial laceration. Complication of external cardiac massage.

Biggart, J. D.; McClure, John N.

doi:10.1136/hrt.37.6.652

Cited by 15 publications

(6 citation statements)

References 1 publication

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“…A broad spectrum of cardiac injuries have been observed including both contusions of the epi-, myo-, or endocardium (4.4%, 1.7%, and 3% respectively) 5–7, 9–11, 18, 26–31 and lacerations or chamber ruptures (0.6%) involving the right atrium, 13, 15, 23, 24 right ventricle, 13, 28, 32–34 left ventricle, 5, 12, 18, 25, 28 or locations not specified. 5, 14, 17 Cardiac rupture has been associated with thoracic wall injuries or myocardium weakened by ischemia.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

et al. 2014

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OBJECTIVE The incidence of thoracic injuries resulting from cardiopulmonary resuscitation (CPR) is not well characterized. We describe a case in which a CPR-associated atrial rupture was identified with ultrasound and successfully managed in the intensive care unit with a bedside thoracotomy and atrial repair. We then describe a systematic review with pooled data analysis of CPR-associated cardiovascular, pulmonary, pleural, and thoracic wall injuries. DATA SOURCES PubMed, Scopus, EMBASE, and Web of Science were searched to identify relevant published studies. Unpublished studies were identified by searching the Australian and New Zealand Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform, Cochrane Library, ClinicalTrials.gov, Current Controlled Trials, and Google. STUDY SELECTION Inclusion criteria for the pooled analysis were any clinical or autopsy study in which a) patients underwent cardiopulmonary resuscitation, b) chest compressions were administered either manually or with the assistance of active compression-decompression devices, and c) autopsy or dedicated imaging assessments were conducted to identify complications. Exclusion criteria for the pooled analysis were pre-clinical studies, case reports and abstracts. DATA EXTRACTION Nine-hundred twenty-eight potentially relevant references were identified. Twenty-seven references met inclusion criteria. DATA SYNTHESIS A systematic review of the literature is provided with pooled data analysis. CONCLUSIONS The incidence of reported CPR-associated cardiovascular and thoracic wall injuries varies widely. CPR with active compression-decompression devices has a higher reported incidence of cardiopulmonary injuries. Bedside ultrasound may be a useful adjunct to assess and risk-stratify patients to identify serious or life-threatening CPR-associated injuries.

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Section: Resultsmentioning

confidence: 99%

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

et al. 2014

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“…With blunt chest injury, the common sites of traumatic cardiac rupture are the right atrium, left ventricle, right ventricle, left atrium, interventricular septum, and valves. 2 The possible mechanisms of injury to the heart in blunt chest injury are: (1) the direct transmission of a sudden rise in intrathoracic or intracardiac pressure to the chambers of the heart; (2) a hydraulic effect produced when a large external force is applied to the veins of the abdomen or an extremity, and the force is transmitted to the right atrium, resulting in rupture; (3) a rapid deceleration force leading to atriocaval tears and disruption of the connections to the superior or inferior vena cava and pulmonary veins situated at the atrial junction; (4) myocardial contusion, ischemia, necrosis, and subsequent cardiac rupture; (5) penetration of the heart (fracture of the ribs or sternum, and bullet wounds); and (6) as an iatrogenic complication. 1,3e5 In conclusion, the results of prenatal examinations showed that the baby was normal, and the mother had planned to deliver the baby by normal spontaneous delivery.…”

Section: Discussionmentioning

confidence: 97%

“…The prognosis usually is unfavorable, even with judicious treatment. 1,2 To the best of our knowledge, there has been no report on right atrial laceration during the perinatal period as a result of blunt injury.…”

Section: Introductionmentioning

confidence: 89%

Hemopericardium from right atrial laceration in a newborn

Chen

Pan

et al. 2011

Journal of the Chinese Medical Association

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“…Right atrial rupture and external cardiac massage Krischer and colleagues [13] have shown cardiovascular lesions to occur in 10.6% of cases in a study of 705 deaths after CPR. Cardiac rupture or laceration may occur primarily because of rib or sternal fractures, insufficient skill of the operator, or preexisting myocardial damage such as myocarditis and acute myocardial infarction [4,16,17]. It also occurs secondary to a stronger compression of the heart between the anterior thoracic wall and the vertebral column.…”

Section: Discussionmentioning

confidence: 99%

Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

et al. 2014

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Background: Isolated right atrial rupture is a very rare catastrophic complication of cardiopulmonary resuscitation. Objective: We described a rare case of right atrial rupture after external cardiac massage. Methods: We reported the case of a 62-year-old male patient who developed excessive bleeding following external cardiac massage for sudden cardiac arrest in the intensive care unit after coronary artery bypass grafting. Results: This man underwent successful emergency repair of the tear of the right atrium without using cardiopulmonary bypass. Conclusion: Right atrial rupture can occur after external cardiac massage. An emergency repair is needed.

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Right atrial laceration. Complication of external cardiac massage.

Cited by 15 publications

References 1 publication

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

Hemopericardium from right atrial laceration in a newborn

Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

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