Analysis Of Surgical Treatment Of Cardiac Rupture

Background Cardiac rupture was once considered to be incurable lethal damage. In 17th century, a French surgeon called Holferius, put forward for the first time that " Cardiac trauma could be cured,and not all cardiac injuries were fatal ".On July 10,1893, Dr. Daniel Hale Williams, a surgeon from Chicago, successfully operated on a 24-year-old man stabbed in the heart during a fight. In 1897, Dr. Ludwig Rehn, a surgeon in Frankfurt, Germany, performed the first successful heart operation on Penetrating Cardiac Trauma (PCT). About 100 years after that, the prognosis of the cardiac rupture had improved gradually with the development of the medical science. However, the Cardiac rupture is still the critical illness in the range of chest trauma, especially Penetrating Cardiac Trauma (PCT). Although the rescue success ratio of the heart penetration wound improves, the mortality rate is still high. According to the relevant foreign reports in the late 1990s, the PCT total mortality rate was 25%-65%. With the development of economy and the increasing use of cars, more and more patients hurt in car accidents taken to the hospital were diagnosed as blunt cardiac rupture(BCR). According to statistics of clinical cases, BCR accounts for about 10% to 20% in the patients suffering blunt chest trauma. The patients with cardiac rupture usually are in the emergency condition, and Hemorrhagic shock and Acute cardiac tamponade are two major reasons for death. Surgery is the main treatment for cardiac rupture, and the outcomes of the PCT operations are greatly different due to the injury mechanism, operation spot, and other clinic conditions.Objective To probe the factors influencing treatment effects and further direct the clinic work through retrospective review of the records of the 19 patients suffering cardiac rupture from August,1985 to November,2008.Methods The clinical data of the 19 cardiac rupture patients who received operations in our hospital from Aug,1985 to Nov,2008 was collected to analyze retrospectively.Results Among all the 19 cases,17 received operations and all survived.2 cases died in the Emergency Room without receiving operations. Success rate was 89.5%.Conclusion The key to the treatment of cardiac rupture is a high index of suspicion, rapid diagnosis, and operative intervention.