Emergency Open Cardiac Massage via Subxyphoid Approach in Ruptured Type A Aortic Dissection

Patient sustained cardiac tamponade caused by rupture of type A aortic dissection may result in sudden death. Pericardiocentesis is a lifesaving procedure; nevertheless, blood may occlude the catheter and fail to relieve the pressure. However, open-chest cardiac massage in resuscitation has been studied in animal models by some medical centers and laboratories with inspiring results. We report a 58-year-old woman who was transferred from a local hospital with the diagnosis of cardiac tamponade caused by ruptured type A aortic dissection. Pulseless electrical activity followed by cardiac arrest occurred thereafter. Successful resuscitation in the emergency department was achieved using open cardiac massage through the sub-xyphoid region by opening a pericardial window. Therefore, in unstable patients with cardiac tamponade due to aortic dissection, this resuscitative procedure is feasible, safe and efficient. CHAO-WEN CHEN ( ) Department of Trauma Kaohsiung Medical University Hospital 100 Tzyou 1st Road Kaohsiung 807, Taiwan Phone: +88673125895 ext 7553 Fax: +88673208255 E-mail: [email protected] HSING-LIN LIN • WEI-CHE LEE • SHING-GHI LIN • LIANG-CHI KUO • YUAN-CHIA CHENG Department of Trauma Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung, Taiwan HSING-LIN LIN • WEI-CHE LEE KUO • YUAN-CHIA CHENG Department of emergency Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung, Taiwan HSING-LIN LIN Division of General Surgery Department of Surgery Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung, Taiwan HSING-LIN LIN MD Graduate Institute of Healthcare Administration Kaohsiung Medical University Kaohsiung, Taiwan HSING-LIN LIN • WEI-CHE LEE • SHING-GHI LIN • LIANG-CHI KUO • YUAN-CHIA CHENG • CHAO-WEN CHEN CASE REPORT SIGNA VITAE 2010; 5(2): 32 -34