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钝性胸部创伤中的冠状动脉破裂:一例报告并文献复习

Coronary artery rupture in blunt thoracic trauma: a case report and review of literature.

作者信息

Abu-Hmeidan Jareer Heider, Arrowaili Arief Ismael, Yousef Raid Said, Alasmari Sami, Kassim Yasser M, Aldakhil Allah Hamad Hamad, Aljenaidel Abdullah Mohammed, Alabdulqader Abdullah Abdulmohsen, Alrashed Muath Hamad, Alkhinjar Mulfi Ibrahim, Al-Shammari Nawwaf Rahi

机构信息

Department of General Surgery, Prince Mohammed bin Abdulaziz Hospital, Al Imam Ahmad Ibn Hanbal Street, Ar Rawabi, Riyadh, 11676, Saudi Arabia.

Department of General Surgery, Al-Imam Muhammad Ibn Saud Islamic University School of Medicine, Airport Road, Riyadh, 13318, Saudi Arabia.

出版信息

J Cardiothorac Surg. 2016 Aug 2;11(1):119. doi: 10.1186/s13019-016-0528-6.

Abstract

BACKGROUND

Blunt thoracic trauma can rarely result in coronary artery injury. Blunt trauma can result in occlusion of any of the coronary arteries or can lead to its rupture and bleeding. Traumatic coronary artery occlusion can lead to myocardial infarction, while its rupture and bleeding can result in hemopericardium and cardiac tamponade, and can be rapidly fatal. Survival after coronary artery rupture in blunt thoracic trauma is exceedingly rare.

CASE PRESENTATION

We present a case of a young male who sustained a blunt thoracic trauma in a motor vehicle collision, that resulted in rupture of the left anterior descending (LAD) coronary artery and subsequent cardiac tamponade. Prompt surgical intervention with pericardiotomy and ligation of the artery has resulted in survival of the patient.

CONCLUSIONS

In cases of traumatic coronary artery rupture, early surgical intervention is crucial to avoid mortality. Ligation of the injured coronary is a viable option in selected cases, and can be the most expeditious option in patients in extremis.

摘要

背景

钝性胸部创伤很少会导致冠状动脉损伤。钝性创伤可导致任何一支冠状动脉闭塞,或导致其破裂和出血。创伤性冠状动脉闭塞可导致心肌梗死,而其破裂和出血可导致心包积血和心脏压塞,并可迅速致命。钝性胸部创伤后冠状动脉破裂仍存活的情况极为罕见。

病例介绍

我们报告一例年轻男性,在机动车碰撞中遭受钝性胸部创伤,导致左前降支(LAD)冠状动脉破裂并随后发生心脏压塞。及时进行心包切开术和动脉结扎的手术干预使患者得以存活。

结论

在创伤性冠状动脉破裂的病例中,早期手术干预对于避免死亡至关重要。在某些特定病例中,结扎受损冠状动脉是一种可行的选择,对于处于危急状态的患者可能是最迅速的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1115/4971721/999a2acb07c4/13019_2016_528_Fig1_HTML.jpg

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