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Signa vitae : journal for intesive care and emergency medicine, Vol. 5. No. 2., 2010.

Professional paper

Emergency Open Cardiac Massage via Subxyphoid Approach in Ruptured Type A Aortic Dissection

Hsing-Lin Lin ; Graduate Institute of Healthcare Administration; Division of General Surgery, Department of Surgery; Department of emergency; Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Wei-Che Lee ; Department of emergency; Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Shing-Ghi Lin ; Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Liang-Chi Kuo ; Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Yuan-Chia Cheng ; Department of emergency; Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Chao-Wen Chen ; Department of Trauma, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road Kaohsiung 807, Taiwan,

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Abstract

Patient sustained cardiac tamponade caused by rupture of type A aortic dissection may result in sudden death. Pericardiocentesis is a lifesaving procedure; nevertheless, blood may occlude the catheter and fail to relieve the pressure. However, open-chest cardiac massage in resuscitation has been studied in animal models by some medical centers and laboratories with inspiring results. We report a 58-year-old woman who was transferred from a local hospital with the diagnosis of cardiac tamponade caused by ruptured type A aortic dissection. Pulseless electrical activity followed by cardiac arrest occurred thereafter. Successful resuscitation in the emergency department was achieved using open cardiac massage through the sub-xyphoid region by opening a pericardial window. Therefore, in unstable patients with cardiac tamponade due to aortic dissection, this resuscitative procedure is feasible, safe and efficient.

Keywords

direct cardiac compression; resuscitation; sub-xyphoid approach; cardiac tamponade; aortic dissection

Hrčak ID:

60166

URI

https://hrcak.srce.hr/60166

Publication date:

1.10.2010.

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