Rupture of the left atrial roof due to blunt trauma

Abstract

Cardiac rupture after blunt trauma is rare and associated with high mortality. The anatomic pattern of blunt cardiac rupture has been demonstrated with the right cardiac chambers more frequently affected than the left. Furthermore, left atrial injury is usually restricted to the atrial appendage and the pulmonary vein-atrial junction. Herein, we report the first case of a 61-year old man with a rupture of the left atrial roof after blunt trauma with minimal thoracic injury.

Survival after pre-hospital emergency clamshell thoracotomy for blunt cardiac rupture

“…The underlying mechanisms of blunt cardiac rupture are unclear but thought to be rapidly increased intra-cardiac chamber pressure as a result of direct impact, increased venous pressure secondary to abdominal and lower limb compression, compression of the heart between the sternum and vertebral column, as well as deceleration forces acting at the junction of mobile and fixed anatomical structures [6].…”

Left atrial appendage tear due to blunt chest trauma: off-pump repair

“…Brathwaite et al [9] reported that left atrial injury occurs in the 25% of the cases with cardiac rupture, and atrial appendage and pulmonary vein-atrial junction are the most affected sides. In a study that reported the anatomical distribution of 42 injuries; the number of patients have affected chambers are; 21 patients (50%) in right atrium, 7 patients (17%) in right ventricle, 10 patients (24%) in left atrium, and 4 patients in left ventricle [10]. Tanoue et al [11] reported a case that they operated because of the rupture of left atrial appendage due to the blunt trauma.…”

The instance when a general surgeon “lost heart:” Isolated blunt traumatic rupture of both atria and pericardium

“…The most common mechanisms of blunt cardiac rupture are described in Table 1 . [ 2 3 4 5 ] The mechanism of the injury in our patient seems to be the compression of the heart between the sternum and vertebral column in late diastole or early systole.…”

“…[ 1 ] The cardiac rupture caused by blunt thoracic trauma is rare, making up 0.041–0.5%; however, resulting in high mortality up to 90%. [ 2 ] The most common cause of blunt injury to heart is motor vehicle accidents, followed by auto-pedestrian accidents, falls from a height, and crash injury. [ 3 ] Rupture of two cardiac chambers is extremely rare, accounting for about 9% of all cardiac ruptures and is associated with extremely high mortality.…”