The doctor performed temporary stitches on the rupture to stop the bleeding and create conditions for resuscitation so the heart could beat again. After 3 stressful hours, surgeons reshaped the ruptured heart chamber.
Patient NVT (30 years old) has a healthy history, no illness and still plays sports regularly. 5 days before coming to the hospital, Mr. T. had coughs, sputum, and had a high fever of 39˚C with a sore throat. The test ruled out fever due to COVID-19.
Seeing fever and extreme fatigue, Mr. T. went to the provincial general hospital for a check-up. Here, doctors discovered that patient T. had a bulge in the posterior wall of the left ventricle, monitored him for infective endocarditis and transferred him to Bach Mai Hospital.
On the night of June 5, 2023, patient T. was transferred to Emergency Resuscitation Unit C1 – Vietnam Heart Institute with a fever of 38 degrees Celsius, mild chest pain, tachycardia… Emergency ultrasound at the bed, Cardiologists saw an aneurysm behind the left ventricle wall. The aneurysm was very thin, so thin that it could rupture at any time. The patient was closely monitored by doctors and prescribed a series of other exploratory tests.
The next morning, the patient suddenly stopped breathing, had a cardiac arrest, and completely lost consciousness. Indicators on monitoring equipment show that the patient has fallen into a state of “clinical death”…
Faced with a critical emergency situation, Associate Professor Dr. Ta Manh Cuong – Deputy Director of the Vietnam Heart Institute, Head of Resuscitation Unit C1 directed the start of the ‘Circulatory Arrest Emergency Team’, the patient received cardiac compression support. on respiration to maintain blood pressure. C1’s intervention team was also immediately mobilized. The ultrasound machine at the emergency bed is pushed to the patient’s side. Ultrasound results showed that the bulge had ruptured. This is the cause of the patient’s “clinical death”.
It was determined that this was a case of heart rupture that required urgent open surgery to relieve blood pressure from overflowing the heart chambers. After only 5 minutes, the patient’s chest was opened, cardiac tamponade was relieved, and extracorporeal circulation was established to maintain basic life functions for the patient. Evaluation of the damage showed that the aneurysm had ruptured, causing blood to rush out and compress the heart, causing the patient to lose blood pressure, go into cardiac arrest, and die clinically.
The doctor performed temporary stitches on the rupture to stop the bleeding and facilitate resuscitation for the heart to beat again. After 3 stressful hours, surgeons reshaped the ruptured heart chamber.
Sharing about the process of performing the surgery, Dr. Duong Duc Hung, Head of Cardiovascular Surgery Unit C8 – Vietnam Heart Institute, said: “Inspecting and re-evaluating the patient’s damage, we found that part of the left ventricle was stretched thin and thin to the point of rupture. It can be said that this is a serious injury, difficult to handle, and the mortality rate is extremely high, especially when the surgery is performed in an emergency state and the patient has had cardiac arrest before surgery.
Firstly, due to the complex pathology, sudden progression and impact on the circulatory system, the patient quickly falls into a state of loss of blood pressure.
Second, the mortality rate is high because the problem is very difficult to treat and requires very quick deployment and high expertise to be able to handle it. All implementations are strictly “time-robbing”, meaning they are only allowed for a few minutes.”
If the heart stops beating for 4-6 minutes, it can cause permanent brain damage and brain death
Also according to Dr. Hung, when the heart stops beating, within just 4-6 minutes, the brain can be permanently damaged or brain dead. Heart rupture will cause bleeding, cardiogenic shock, and severe heart failure. The death rate from heart failure is up to 90%.
Not to mention, if the “broken heart” is not surgically opened and decompressed in time, the pressure prevents blood from being pumped to the brain. In just about 5-6 minutes, the patient will lose his brain. If they can be saved, the patient will only live a “vegetative” life…
In the case of patient T., who had cardiac arrest, doctors had to perform cardiac compression (CPR) and push him to the operating room. In just the “blink of an eye”, the entire team of internal cardiologists, cardiologist surgeons, radiologists, online emergency system… experienced physicians in handling serious cases have devoted all their efforts. force, racing against time to save the sick from the “scythe of death”.
After the “speedy” surgery, the patient was transferred to the recovery area. At this time, another concern arose about the patient’s brain damage, after a fairly long period of circulatory arrest. All The best techniques, the best drugs, and the best equipment for cardiopulmonary resuscitation and cerebral resuscitation were applied to patient T. After 3 days, the patient regained consciousness. After 5 days, the patient could sit up and talk.
By saving the life of this special patient, doctors believe that the internal-surgical coordination model in cardiology as well as in other specialties needs to be developed at all levels to improve the quality of treatment. save more sick people’s lives.
Orpha Spinka