Nonpenetrating right atrial and pericardial trauma

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Nonpenetrating right atrial and pericardial trauma Antonino M Grande, MD, Mauro Rinaldi, MD, Stefano Pasquino, MD, Roberto Dore, MD, Mario Viganò, MD The Annals of Thoracic Surgery Volume 76, Issue 3, Pages 923-925 (September 2003) DOI: 10.1016/S0003-4975(03)00197-8

Fig 1 Computed tomography angiogram. (A) Right atrium appears in apparent normal shape during first phases of contrast enhancement. An anterior mediastinal hematoma (arrows) is near the atrium and a layer of fluid collection is in the mediastinal right pleura. (DA = descending aorta; la = left atrium; ra = right atrium.) (B) Mediastinal hematoma (arrows) and anterosuperior portions of the pericardium with bleeding. The shape of the ascending aorta and the superior vena cava is normal. (A = aorta; lpa = left pulmonary artery; lspv = left superior pulmonary vein; PT = pulmonary trunk; rpa = right pulmonary artery; svc = superior vena cava.) The Annals of Thoracic Surgery 2003 76, 923-925DOI: (10.1016/S0003-4975(03)00197-8)

Fig 2 Late scan demonstrates active bleeding in the anterosuperior pericardial portions, which show late contrast enhancement as great vessels. No active bleeding is in the mediastinal hematoma (arrows) or in the right mediastinal pleural space. (A = aorta; DA = descending aorta; lpa = left pulmonary artery; PT = pulmonary trunk; ra = right atrium; rpa = right pulmonary artery.) The Annals of Thoracic Surgery 2003 76, 923-925DOI: (10.1016/S0003-4975(03)00197-8)

Fig 3 Operative finding: right atrial laceration near the atriocaval junction. The Annals of Thoracic Surgery 2003 76, 923-925DOI: (10.1016/S0003-4975(03)00197-8)

Fig 4 Operative finding: wide pericardial lacerations of the pericardium on its lateral aspect facing the superior and inferior venae cavae. The Annals of Thoracic Surgery 2003 76, 923-925DOI: (10.1016/S0003-4975(03)00197-8)