Patient D.C.T (38 years old, residing in Ho Chi Minh City) was brought to the emergency room on April 23 in a state of severe blood loss due to a left chest wound about 3cm long, sharp edges, and continuous bright red bleeding.
Through examination and ultrasound at the Emergency Department, Thong Nhat Hospital, doctors recorded bleeding from the pericardium and left pleural effusion. The patient's blood pressure gradually decreased, and his perception quickly deteriorated. Doctors immediately activated the whole hospital red alert, transferred the patient to the Department of Anesthesia and Resuscitation Surgery to deploy emergency surgery, and completed administrative procedures later.
When performing emergency breast augmentation, doctors both performed surgery and intensive resuscitation to compensate for blood loss to maintain blood pressure. Doctors recorded about 800ml of blood in the pericardium causing heart compression and about 1,800ml of blood clots mixed with thin blood in the left pleural cavity.
After sucking out the blood in the thoracic cavity, the team discovered many serious lesions: a right ventricular puncture wound about 6-7cm long, a tear in the left pericardium and a lesion in the left lower lobe of the lung about 6cm long.
The treatment process faced many challenges because the patient had a history of severe burns to 60% of her body 6 years ago, leaving scars contracting the chest, neck and mouth area, causing difficulties in anesthesia and endotracheal intubation. Deformation of skin and chest wall due to old burns also complicated the surgery.
Dr. Truong Nguyen Hoai Linh - Department of Cardiovascular Surgery - Thoracic Surgery, Thong Nhat Hospital said: "Patients with right ventricular perforation wounds are about 6-7cm long, located between two large coronary arteries. This is a particularly dangerous position, requiring absolutely accurate sewing and patching techniques. Sewing too tightly can cause coronary artery blockage leading to myocardial infarction, while sewing not tightly will cause postoperative bleeding.
Thanks to the smooth coordination between specialties, the heart wound has been successfully treated, blood flow is well controlled and heart function is preserved. After intensive treatment, the patient's health has now stabilized and is expected to be discharged from the hospital in the next few days.
