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Cardiovascular and metabolic science
versão On-line ISSN 2954-3835versão impressa ISSN 2683-2828
Resumo
VALDES-DUPEYRON, Osvaldo et al. Trap-door thoracotomy as an ideal access route for internal cardiac massage and repair of subclavian vessels. Cardiovasc. metab. sci [online]. 2023, vol.34, n.2, pp.59-65. Epub 15-Abr-2024. ISSN 2954-3835. https://doi.org/10.35366/111548.
Introduction:
subclavian vessel injuries remain rare and highly lethal. Patients with these types of injuries can present with neck and upper chest hematoma, hemorrhage, and signs of upper limb ischemia. Trap-door thoracotomy allows wide exposure of the thoracic cavity and base of the neck, providing rapid access to the heart, subclavian vessels, pulmonary ileus, and other anterior mediastinal structures.
Objective:
to describe the trap-door thoracotomy as the ideal approach for internal cardiac massage and subclavian vascular repair in hemodynamically unstable patients. Cases presentation: two patients with severe subclavian artery injuries are presented. They underwent emergency surgery using a trap-door thoracotomy, where bypass was performed from the ascending aorta to the left axillary artery with a polytetrafluoroethylene prosthesis in the first case and bypass from the left carotid artery to the left subclavian artery with an inverted saphenous vein in the second patient.
Conclusion:
the trap-door thoracotomy allows optimal access to the subclavian vessels and the heart if cardiopulmonary resuscitation is needed in critically ill patients.
Palavras-chave : subclavian artery lesions; Trap-door thoracotomy; subclavian artery revascularization; internal cardiac massage.