Left atrial appendage tear due to blunt chest trauma: off-pump repair

Abstract

Left atrial appendage tear due to blunt trauma is a very rare clinical entity with high mortality rates. Traumatized patients may have no symptoms, or be in a cardiogenic shock state. For diagnosis, it is crucial to determine hemopericardium by echocardiography. Herein, we report a 28-year-old male patient who developed left atrial appendage tear following a fall from a higher distance. He underwent successful off-pump repair of the tear through a median sternotomy. 

Keywords

• Left atrial appendage tear
• blunt chest trauma
• off-pump
• surgery

References

1. Schultz JM, Trunkey DD. Blunt cardiac injury. Crit Care Clin 2004;20:57-70.
2. Turk F, Ozcan V, Yuncu G, Ekinci Y, Girgin S. [An isolated right auricular rupture following blunt chest trauma causing massive hemothorax]. Turk Gogus Kalp Dama 2014;22:410-3. [Article in Turkish]
3. Adalia R, Sabater L, Azqueta M, Muntanya X, Real MI, Riambau V, et al. Combined left ventricular aneurysm and thoracic aortic pseudoaneurysm caused by blunt chest trauma. J Thorac Cardiovasc Surg 1999;117:1219-21.
4. Teixeira PG, Inaba K, Oncel D, DuBose J, Chan L, Rhee P, et al. Blunt cardiac rupture: a 5-year NTDB analysis. J Trauma 2009; 67:788-91.
5. 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.
6. Nan YY, Lu MS, Liu KS, Huang YK, Tsai FC, Chu JJ, et al. Blunt traumatic cardiac rupture: therapeutic options and outcomes. Injury 2009;40:938-45.
7. Alameddine AK, Alimov VK, Alvarez C, Rousou JA. Unexpected traumatic rupture of left atrium mimicking aortic rupture. J Emerg Trauma Shock 2014;7:310-2.
8. Ata Y, Turk T, Yalcin M, Selimoglu O, Ozyazicioglu A, Yavuz S. [Heart Injuries]. IU Kardiyol Enst Derg 2009;8:16-9. [Article in Turkish]

9. Braithwaite CE, Rodriguez A, Turney SZ, Dunham CM, Cowley R. Blunt traumatic cardiac rupture: a 5-year experience. Ann Surg 1990; 212:701-4.
10. Ryu DW, Lee SY, Lee MK. Rupture of the left atrial roof due to blunt trauma. Interact Cardiovasc Thorac Surg 2013;17:912-3.
11. Tanoue K, Sata N, Moriyama Y, Miyahara K. Rupture of the left atrial ‘basal’ appendage due to blunt trauma in an elderly patient. Eur J Cardiothorac Surg 2008;34:1118-9.
12. Akar I, Ince I, Aslan C, Ceber M, Kaya I. Left atrial rupture due to blunt thoracic trauma. Ulus Travma Acil Cerrahi Derg 2015;21:303-5.