Use of the EVARREST patch for penetrating cardiac injury

Trauma Case Reports
Gustavo Romero-VelezSrinivas H Reddy

Abstract

Penetrating cardiac injuries have a pre-hospital mortality of 94% with a subsequent in-hospital mortality of 50% among initial survivors (Leite et al., 2017 [1]). The Western Trauma Association (WTA) guidelines recommend resuscitative thoracotomy (RT) for patients with penetrating torso trauma and less than 15 min of cardiopulmonary resuscitation (CPR) Burlew et al. (2012) [2]. Penetrating cardiac injuries are classically repaired using skin-stapling devices and/or suture repair with or without pledgets (Wall et al., 1997 [3]). In this study, we present a case of penetrating cardiac injury where all the aforementioned techniques failed, and a new approach was explored. A fibrinogen/thrombin patch was used in this clinical setting, which is an off-label use of the product, we here present our encouraging outcome.

References

May 1, 1997·The Journal of Trauma·M J WallJ C Baldwin
Nov 29, 2012·The Journal of Trauma and Acute Care Surgery·Clay Cothren BurlewWalter L Biffl
Dec 12, 2012·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jonathan B KoeaO James Garden
May 24, 2016·The Annals of Thoracic Surgery·William Feng, Michael Coady
Aug 30, 2017·Journal of Forensic and Legal Medicine·Luís LeiteDuarte Nuno Vieira
Jul 15, 2018·Military Medicine·Jennifer E BakerKrishna P Athota
Nov 21, 2018·Radiologic Clinics of North America·Demetrios A RaptisConstantine A Raptis

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