Delayed Presentation of Traumatic Pericardial Rupture: Diagnostic and Surgical Considerations for Treatment

  • Amy G Fiedler Division of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA.
  • Puja Banka Division of Cardiology, Boston Children’s Hospital, Boston, MA, USA.
  • Katherine Zaleski Division of Cardiac Anesthesiology, Boston Children’s Hospital, Boston, MA, USA.
  • Michael C Fahey Division of Pediatric Cardiology, University of Massachusetts, Worcester, MA, USA.
  • Roger E Breitbart Division of Cardiology, Boston Children’s Hospital, Boston, MA, USA.
  • Francis Fynn-Thompson Division of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA.
Keywords: cardiac trauma, pericardial rupture

Abstract

Traumatic pericardial rupture is a rare event with high mortality. We present the case of a 15-year-old boy who sustained thoracic and abdominal trauma secondary to motor vehicle collision, with a delayed diagnosis of traumatic pericardial rupture with cardiac herniation. Out of concern for torsion and hemodynamic collapse, surgical repair was advised. We have developed a novel surgical approach to this rare condition, utilizing a combination of thoracoscopic and open surgical techniques. The guiding principles of our repair include the utilization of fenestrated pieces of bovine pericardium to create a tension free repair, minimizing the likelihood of pericardial effusion, and returning the cardiac mass to normal anatomic position.

Author Biography

Amy G Fiedler, Division of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA.
Cardiothoracic Surgery Resident

References

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Published
2018-06-14
Section
Articles