A pilot experimental study of a catheter to facilitate treatment for penetrating cardiac injury
Penetrating heart injuries result in high mortality. We designed a new catheter to facilitate the treatment of penetrating cardiac injuries and provide more effective initial bleeding control and fluid replacement. Materials and methods: The cardiac injury model was applied to 8 female 1-year-old Sus domesticus pigs. Subjects were grouped according to whether a Foley catheter or a newly designed catheter was placed into the heart through cardiac lacerations. Changes in systolic blood pressures, mortality, and problems encountered during surgery and other intraoperative findings were recorded. Results: There were higher mean blood pressure measurements in the newly designed catheter group during stages IV to VII. All subjects had tamponade and cardiac activity after completion of the repair of all lacerations in the catheter group, whereas in the other group only one subject did. Intraoperative direct fluid infusion to the heart through the catheters in the diastole was performed in all subjects of both groups. However, regurgitation from the cardiac cavity in the systole was seen only in the Foley catheter group. All of the intraoperative complications were seen in the same group. Conclusion: The newly designed catheter can provide effective initial bleeding control, better initial vital sign stabilization, and fewer intraoperative problems during primary repair of cardiac lacerations.
A pilot experimental study of a catheter to facilitate treatment for penetrating cardiac injury
Penetrating heart injuries result in high mortality. We designed a new catheter to facilitate the treatment of penetrating cardiac injuries and provide more effective initial bleeding control and fluid replacement. Materials and methods: The cardiac injury model was applied to 8 female 1-year-old Sus domesticus pigs. Subjects were grouped according to whether a Foley catheter or a newly designed catheter was placed into the heart through cardiac lacerations. Changes in systolic blood pressures, mortality, and problems encountered during surgery and other intraoperative findings were recorded. Results: There were higher mean blood pressure measurements in the newly designed catheter group during stages IV to VII. All subjects had tamponade and cardiac activity after completion of the repair of all lacerations in the catheter group, whereas in the other group only one subject did. Intraoperative direct fluid infusion to the heart through the catheters in the diastole was performed in all subjects of both groups. However, regurgitation from the cardiac cavity in the systole was seen only in the Foley catheter group. All of the intraoperative complications were seen in the same group. Conclusion: The newly designed catheter can provide effective initial bleeding control, better initial vital sign stabilization, and fewer intraoperative problems during primary repair of cardiac lacerations.
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- Campbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. Review of 1198 cases of penetrating cardiac trauma. Br J Surg 1997; 84: 1737–1740.
- Tokur M, Ergin M, Okumus M, Kurkcuoglu C. Penetrating heart injuries due to puncture by fractured sternum or ribs following blunt trauma. J Curr Surg 2011; 1: 38–40.
- Mittal V, McAleese P, Young S, Cohen M. Penetrating cardiac injuries. Am Surg 1999; 65: 444–448.
- Tokur M, Ergin M, Kurkcuoglu C. Penetrating heart injuries and common difficulties encountered during emergency surgery. J Curr Surg 2012; 2: 89–95. 5. Arıkan S, Yücel AF, Kocakusak A, Daduk Y, Adas G, Onal MA. Penetran kardiyak travmalı hastaların retrospektif analizi. Ulus Travma Acil Cerrahi Derg 2003; 9: 124–128 (in Turkish).
- Fedakar R, Turkmen N, Durak D, Gundogmus UN. Fatal traumatic heart wounds: review of 160 autopsy cases. Isr Med Assoc J 2005; 7: 498–501. 7. Ivatury RR, Rohman M, Steichen FM, Gunduz Y, Nallathambi M, Stahl WM. Penetrating cardiac injuries: twenty-year experience. Am Surg 1987; 53: 310–317.
- Henderson VJ, Smith RS, Fry WR, Morabito D, Peksin GW, Barkan H, Organ CH Jr. Cardiac injuries: analysis of an unselected series of 251 cases. J Trauma 1994; 36: 341–348.
- Tyburski JG, Astra L, Wilson RF, Dente C, Steffes C. Factors affecting prognosis with penetrating wounds of the heart. J Trauma 200; 48: 587–90.
- Thourani VH, Feliciano DV, Cooper WA, Brady KM, Adams AB, Rozycki GS, Symbas PN. Penetrating cardiac trauma at an urban trauma center: a 22-year perspective. Am Surg 1999; 65: 811–818.
- Çakır Ö, Eren Ş, Balcı AE, Özçelik C, Eren N. Penetran kalp yaralanmaları. Türk Göğüs Kalp Damar Cer Derg 1999; 7: 112–116 (in Turkish).
- Asensio JA, Berne JD, Demetriades D, Chan L, Murray J, Falabella A, Gomez H, Chahwan S, Velamhos G, Cornwell EE et al. One hundred five penetrating cardiac injuries: a 2-year prospective evaluation. J Trauma 1998; 44: 1073–1082.
- Moreno C, Moore EE, Majure JA, Hopeman AR. Pericardial tamponade: a critical determinant for survival following penetrating cardiac wounds. J Trauma 1986; 26: 821–825.
- Gao JM, Gao YH, Wei GB, Liu GL, Tian XY, Hu P, Li CH. Penetrating cardiac wounds: principles for surgical management. World J Surg 2004; 28: 1025–1029.
- Ivatury RR. The injured heart. In: Mattox KL, Feliciano DV, Moore EE, editors. Trauma. 4th ed. New York, NY, USA: McGraw-Hill; 2000. pp. 545–558.
- Chang WY, Hsu JY, Chang YP, Chao CS, Chang KJ. The successful management of a penetrating cardiac injury in a regional hospital: a case report. J Emerg Crit Care Med 2008; 19: 160–164.