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Ann Thorac Surg 2002;73:342
© 2002 The Society of Thoracic Surgeons

Correspondence

Induced ventricular fibrillation in the management of aortic arch trauma

Francis Robicsek, MD, PhDa

a The Carolinas Heart Institute, 1000 Blythe Boulevard, Charlotte, NC 28203, USA

To the Editor

We read with interest in the May 2001 issue of The Annals the article by Dr Lim and associates [1]. In summary, the authors recommend that penetrating cardiac injuries be repaired during temporary cardiac arrest. This has been achieved in their clinical practice by intravenous injection of adenosine.

Temporary short-lasting circulatory arrest as an adjunct to repair injuries of the heart and the aorta was first recommended by the great Japanese surgeon Juro Wada in the 1970s [2] and reemphasized by us a few years later [3]. We found it a most effective and occasionally a life-saving situation, which greatly simplified suturing holes in both the heart and the aorta. We, however, applied artificially induced ventricular fibrillation, a maneuver that could be easily accomplished by homemade fibrillators, instead of pharmacologic ventricular asystole. Having used it in a good number of patients, we found it an easy and probably safer method than pharmacologic asystole to handle penetrating injuries of the large vessels of the heart.

References

  1. Lim R., Gill I.S., Temes R.T., Smith C.E. The use of adenosine for repair of penetrating cardiac injuries: a novel method. Ann Thorac Surg 2001;71:1714-1715.[Abstract/Free Full Text]
  2. Wada J. Electrically induced fibrillation in cardiac arrest and resuscitation. In: Stephenson HE, ed. Cardiac arrest and resuscitation. St. Louis: CV Mosby Co, 1974:783–95.
  3. Robicsek F., Matos-Cruz M. Artificially induced ventricular fibrillation in the management of through-and-through penetrating wounds of the aortic arch: a case report. Surgery 1991;10:544-545.

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Ann. Thorac. Surg. 2002 73: 343. [Extract] [Full Text] [PDF]




This Article
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Francis Robicsek
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