Abstract
In cardiac trauma there are two basic scenarios:
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1.
The patient is stable. In this case the best access is median sternotomy, because:
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It is less painful for the patient
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The exposure for the heart and the great vessels is optimal
The disadvantage is that this approach provides limited access to other potentially injured structures, such as the lung, subclavian vessels, aorta, and intercostal vessels.
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2.
The patient is unstable. In this case the anterolateral thoracotomy offers several advantages:
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It is faster
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It can be made with basic instruments
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It allows access to several structures besides the heart
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Both techniques are described in Chap. 2.
Once the chest has been opened, the surgeon may find:
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Cardiac tamponade
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Hemothorax if the wound on the pericardium is a big one
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Aida H, Kagaya S. Experience of surgical repair for cardiac trauma [Japanese]. Kyobu Geka. 2018;71(9):643–7.
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The sac is captured with a Kelly forceps and the incision is made with a scissor, avoiding the phrenic nerve (MP4 11666 kb)
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Ferrada, R. (2020). Cardiac Penetrating Trauma. In: Ferrada, P., Ferrada, R. (eds) Atlas of Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-26871-8_3
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DOI: https://doi.org/10.1007/978-3-030-26871-8_3
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