Blunt traumatic rupture of right ventricle and pericardium

A 60-year-old man was transferred to our hospital for blunt trauma of the chest suffered in a traffic accident. He had a weak pulse, and cardiopulmonary resuscitation was continued in the ambulance. Chest roentgenography revealed left hemothorax, and echocardiography revealed pericardial bleeding. He was immediately transported to the operating room, because of severe hypotension due to massive bleeding from the chest drainage tube. Median sternotomy was performed under stand-by cardiopulmonary bypass. There was projectile bleeding from the anterior wall of the right ventricle. The site of rupture was sutured with felt strip. A tear in the pericardium was also present at the apex. Postoperative recovery was uneventful. Fulda et al. reported that the incidence of combined pericadial and cardiac chamber rupture was 8% for those patients suffering blunt chest trauma, and that the rate of survival was less than 15% for blunt heart rupture. We have reported here successful repair of combined rupture of the right ventricle and pericardium.