Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany.
Ann Thorac Surg. 2013 Apr;95(4):1445-7. doi: 10.1016/j.athoracsur.2012.09.043.
Although cardiac contusions are common, cardiac rupture is an uncommon sequela of blunt chest trauma. The mortality rate associated with cardiac rupture is very high, and patients usually do not survive long enough to reach the hospital. We report a 66-year-old man with a history of coronary artery bypass grafting 15 years previously, who was involved in a traffic accident and experienced multiple trauma, including a small contained rupture of the right ventricular outflow tract. He survived, and a false aneurysm developed at the site of the rupture within the next 6 months. The patient then underwent a cardiac operation, and the aneurysm was successfully resected. The intraoperative and postoperative courses were uneventful. In this case, the previous cardiac operation with the resulting pericardial adhesions proved to be lifesaving.
虽然心脏挫伤很常见,但心脏破裂是钝性胸部创伤的罕见后遗症。心脏破裂相关的死亡率非常高,患者通常没有足够的时间到达医院。我们报告了一例 66 岁的男性,他 15 年前曾接受过冠状动脉旁路移植术,在一次交通事故中受到多处创伤,包括右心室流出道的小范围破裂。他幸存下来,6 个月后在破裂部位形成了假性动脉瘤。随后患者接受了心脏手术,成功切除了动脉瘤。手术过程和术后恢复都很顺利。在这种情况下,之前的心脏手术和由此产生的心包粘连被证明是救命的。