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

Authors
Publisher
Pharmamed Mado Ltd.
Publication Date
Keywords
  • Direct Cardiac Compression
  • Resuscitation
  • Sub-Xyphoid Approach
  • Cardiac Tamponade
  • Aortic Dissection
Disciplines
  • Medicine

Abstract

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.

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