Miracle of saving a child with a ruptured heart at Nghe An Maternity and Pediatrics Hospital

NAT's family said: On June 14, while playing in the yard, the child accidentally climbed onto an electric motorbike without adult supervision. The heavy vehicle fell on top of him, crushing his chest. NAT fainted and was taken to the hospital for emergency treatment.

NAT patient admitted to hospitalNghe An Obstetrics and Pediatrics HospitalAt noon on June 14, the patient was in a state of shock, with a rapid, weak pulse, agitated and at risk of death. After first aid, the patient was urgently transferred to the Department of Surgical Resuscitation.

Here, doctors performed intensive resuscitation: The patient was given fluid replacement, mechanical ventilation, central venous catheter placement, and arterial catheterization combined with the use of 3 types of vasopressor drugs to control hemodynamics to maintain vital functions.

NAT patient had an echocardiogram right at the hospital bed… The echocardiogram results showed an image of acute pericardial effusion causing acute cardiac tamponade. This is the cause of the situation where the child can have cardiac arrest and die in a split second.

Faced with the urgent situation, the Department of Surgical Resuscitation raised the red alert for the entire hospital, mobilizing a team of Cardiologists, Surgical Resuscitation, Anesthetists and General Surgeons to consult. The team agreed that the child had a ruptured heart due to a closed chest injury, and emergency surgery was indicated.

The open heart surgery and anesthesia team raced against time to save the child. As soon as the chest was opened, blood gushed out from the pericardial cavity in large quantities.SurgeryThe surgeon observed that the child's heart had a tear in the right atrium about 1.5 cm close to the inferior vena cava. Very quickly, the surgeon sutured the child's heart rupture, controlled the bleeding, drained the pericardium and mediastinum, and closed the chest.

The emergency surgery ended. The patient was transferred to the Surgical Intensive Care Unit for further monitoring and treatment. With the dedicated efforts of the medical team and doctors from various specialties, the child gradually regained consciousness, had the endotracheal tube and drainage removed, his cardiovascular and respiratory functions stabilized and he was soon discharged safely.

Heart rupture often has very complex injuries, very high mortality rate, especially major injuries if not performed by specialized cardiovascular facilities due to lack of cardiopulmonary equipment, surgical experience and cardiovascular anesthesia and resuscitation.

In the case of NAT, if treatment had been delayed by just a few minutes, the child would have had no chance of survival. The doctors' acumen, experience in pediatric heart surgery and decisiveness in emergency care saved the patient's life in this case.