Delayed blow-out type rupture of the right ventricle following blunt chest trauma.

A 36-year-old man suffered multiple traumatic injuries when he fell from a crane. Fractures of both lower extremities, a compression fracture of the fourth lumbar vertebra, and bilateral hemopneumothoraxes were identified. The sternum was not fractured, but was tender. The day after admission, the right ventricular free wall ruptured and was diagnosed by echocardiography. An emergency operation was performed. A Gore-tex sheet was sutured from inside the ventricle, and a Hemashield graft was sutured over the tear. The risk of hemorrhage is high in the patient with multiple traumatic injuries when heparin is required. Mechanical ventilation was required until the 13th postoperative day because persistent hemothorax. After an operation to reduce a leg fracture, the patient was discharged from the hospital on the 66th postoperative day.