Survival Following Traumatic Ventricular Rupture and Prolonged Ambulance Transport in a Patient With Previous Coronary Artery Bypass Surgery

Abstract

Patients presenting with traumatic cardiac rupture are unlikely to survive lengthy transfers from the trauma scene to a hospital. However, in patients with a previous sternotomy, adhesions may divert cardiac hemorrhage, allowing hemodynamic management to be successful. We present an 83-year-old male with a history of coronary artery bypass grafting (CABG) who sustained a right ventricular rupture. He underwent an immediate redo sternotomy and was discharged 10 days postoperatively with no complications.

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

“…Should RV rupture occur a number of years post-operation, it may not cause tamponade, and the patient may be saved by an operation to repair the damage. 6–8 This is because pericardial adhesions formed after a sternotomy, may prevent cardiac hemorrhage and protect against cardiac tamponade. 14 …”

“… 6 The existence of a previous sternotomy, proves to be a factor that increases the mortality (mostly due to pericardial adhesions). 6–8 …”