Tun Myint, Massalis John, Diaconescu Bogdan, Degiannis Elias
Chirurgia (Bucur). 2017 Sept-Oct;112(5):619-623. doi: 10.21614/chirurgia.112.5.619.
During the history operative repair of cardiac injuries was considered to be unmanageable and the first successful cardiomiorraphy was performed just around a century ago. Tamponade, more frequently than exsanguination are cause of death in penetrating cardiac trauma. This is a usualy lethal injury and those surviving to hospital have an overall mortality approaching 80%. The penetrating injury require some basic steps, not special operative dexterity. We present the technical management of this injury, certain danger points and pitfalls. Options for surgical exposure, technical details of suturing cardiac injuries, and exceptional conditions such as injury near the coronary artery are discussed in detail. Outcome data and future directions in managing this injury are also examined.
在历史上，心脏损伤的手术修复曾被认为是无法处理的，而第一例成功的心脏缝合术是在大约一个世纪前进行的。心包填塞比出血更常是穿透性心脏创伤的死亡原因。这是一种通常致命的损伤，那些存活到医院的患者总体死亡率接近80%。穿透性损伤需要一些基本步骤，而非特殊的手术技巧。我们介绍这种损伤的技术处理、某些危险点和陷阱。详细讨论了手术暴露的选择、缝合心脏损伤的技术细节以及诸如冠状动脉附近损伤等特殊情况。还研究了处理这种损伤的结果数据和未来方向。
