What Is Ventricular Drainage?

Pericardial injuries can be of two types: pleural-pericardial laceration and sacral-pericardial laceration. The former can cause pericardial, left or right pleural-pericardial tears due to blunt impact from front to back; it can also cause myocardial contusion. pericardial lacerations often coexist with diaphragm rupture. Simple pericardial laceration, if the cut is small, blood pericardium or acute cardiac tamponade can occur; if the cut is large, the most critical situation is the occurrence of cardiac dislocation and hernia into the pleural cavity, called pericardial hernia. When a pericardial laceration occurs, abdominal organs can enter the pericardial cavity, which is called an intrapericardial diaphragmatic hernia. A dislocated heart or incarceration of the abdominal organs at the rupture can cause severe circulatory dysfunction.

Pericardial drainage

Right!

Pericardial injuries can be of two types: pleural-pericardial laceration and sacral-pericardial laceration. The former can cause pericardial, left or right pleural-pericardial tears due to blunt impact from front to back; it can also cause myocardial contusion. pericardial lacerations often coexist with diaphragm rupture. Simple pericardial laceration, if the cut is small, blood pericardium or acute cardiac tamponade can occur; if the cut is large, the most critical situation is the occurrence of cardiac dislocation and hernia into the pleural cavity, called pericardial hernia. When a pericardial laceration occurs, abdominal organs can enter the pericardial cavity, which is called an intrapericardial diaphragmatic hernia. A dislocated heart or incarceration of the abdominal organs at the rupture can cause severe circulatory dysfunction.

Pericardial drainage

Pericardial fenestration

Cardiovascular Surgery / Heart Trauma Surgery / Surgical Treatment of Non-penetrating Heart Injury / Surgical Treatment of Pericardial Injury / Surgical Treatment of Blood Pericardial and Acute Cardiac Tamponade

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When the pericardial puncture was performed in the blood pericardium, about 25% of the cases could not draw blood. At this time, there were still symptoms of acute cardiac tamponade, and the pericardial windowing could be performed immediately.

A small amount of blood in the pericardium and the enlargement of the heart are contraindications to pericardial windowing.

Surgery is performed under local anesthesia, supine position, or upper body slightly elevated. The disinfection scope of the surgical field should include the chest and upper abdomen to extend the incision if necessary.

1. Make a 5cm incision in the midline of the xiphoid process and cut the white line of the abdomen.

2. Remove the xiphoid process, push open the pleura on both sides, partly open the diaphragm, and then cut the heart bag.

3. Pull the broken end of the sternum to open a small window on the anterior and inferior pericardium, and suspend the pericardium with a 4-pin traction line to clear the blood in the pericardial cavity.

4. Explore and stop bleeding, no active bleeding point, place the pericardial drainage tube, and close the upper abdominal incision loosely.

5. If it is found that the pericardial cavity is still bleeding, immediately make a midline chest incision, expand the pericardial incision, look for the source of bleeding, and suture the heart or pericardial injury.

1. When the incision is extended through the incision, the pleura on both sides should be pressed close to the chest wall to avoid puncturing the pleura.

2. When separating posterior xiphoid tissue, do not cut through the diaphragm to prevent entry into the peritoneal cavity.