Treatment os severe atrial injuries.

Four cases of severe atrial trauma are presented. These cases are unusual because of the magnitude of injury and because of their presentation in hospitals not usually involved in cardiac surgery. Three of the patients had blunt atrial injury. We found only 21 other successfully treated blunt atrial tears in our search of the world's literature. In patients with blunt atrial injuries, the setting of a high speed vehicle accident, significant chest trauma, hypotension, mental confusion and increased venous pressure should alert the emergency physician to the possibility of cardiac rupture. The use of simple operative techniques and the knowledge that most cardiac ruptures repaired successfully involve the atrium may help the surgeon produce a successful outcome.