An Emergency Adaptation of Anterolateral and Clamshell Thoracotomy for Blunt Traumatic Right Atrial Rupture: A Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 11; p. e49208
• Main Authors: Alfraidy, Doaa, Aldarsouni, Fayez G, Dagestani, Hatoon, Al Ramahi, Ghassan Z
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 21.11.2023
• Subjects: Abdomen; Cardiac arrest; Case reports; Electrocardiography; Emergency medical care; Heart; Hemodynamics; Injuries; Laparotomy; Liver; Medical imaging; Mortality; Ostomy; Patients; Pericardium; Surgery; Tomography; Trauma; United States > US; acute care surgery and trauma; bilateral anterolateral thoracotomy; intraop bleeding; sternotomy; emergency critical care; anterolateral thoracotomy; cardio thoracic surgery; clamshell thoracotomy; mediastinal trauma; blunt cardiac trauma
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.49208

The high mortality rate of blunt cardiac injuries is primarily due to the condition's severity and the challenges associated with pre-hospital survival. The absence of definitive diagnostic modalities necessitates prompt and adaptable surgical intervention. We present an 18-year-old male who sustained a right atrial blunt traumatic cardiac rupture following a motor vehicle collision. Despite initial stabilization with blood products and vasopressors and the necessitated emergent surgical exploration, the case required various surgical techniques, including anterolateral followed by an extension to a clamshell thoracotomy and laparotomy to manage the complex cardiac rupture and associated injuries. Furthermore, it underscores the critical nature of surgical incision in such patients and its impact on the overall prognosis. The successful outcome, highlighted by intraoperative decision-making and proper postoperative care, demonstrates that with timely and adaptable surgical approaches, even the most severe cases of traumatic blunt cardiac ruptures can be managed effectively.