Cardiac and great vessel injuries in children after blunt trauma: An institutional review

Purpose: The purpose of this study was to review the incidence of cardiac a nd great vessel injury after blunt trauma in children. Method: A retrospective review of 2,744 patients with injuries from blunt m echanisms was performed. Results: Eleven patients sustained cardiac injury. Four patients had clinic ally evident cardiac contusions. All recovered. Four patients who died from central nervous system injury were found to have cardiac contusions at aut opsy. None had clinical evidence of contusion before demise. One patient ha d a traumatic ventricular septal defect (VSD) that required operative repai r. Autopsy findings showed a VSD in another patient, and a third patient wa s found to have a ventricular septal aneurysm that was treated medically. T wo patients had great vessel injuries. One patient had a contained disrupti on of the superior vena cava that was man-aged nonoperatively. Another pati ent had a midthoracic periaortic hematoma without intimal disruption found at autopsy. One patient had cardiac and great vessel injuries, Discrete ane urysms of 2 coronary artery branches and the pulmonary outflow tract were i dentified by cardiac catheterization. This patient was treated nonoperative ly. Conclusions: Cardiac and great vessel injury after blunt trauma are uncommo n in children. Cardiac contusion was the most common injury encountered but had minimal clinical significance. Noncontusion cardiac injury is rare. No patient with aortic transection was identified, Copyright (C) 2000 by W.B. Saunders Company.