Surgical management and treatment of a traumatic right atrial rupture.

We have treated three patients with blunt traumatic right atrial rupture, all of whom survived after an emergent cardiac repair without cardiopulmonary bypass. Cardiac tamponade was seen in two of the three cases on ultrasonographic cardiography (UCG). The site of rupture was the right atrial appendage in two cases and the superior vena cava-right atrial (SVC-RA) junction in one case. Hemostasis had been obtained at the time of pericardiotomy because of compression by hematoma. Some patients with a right atrial rupture respond to initial volume resuscitation. Suspecting some cardiac injuries in patients with traumatic pericardial effusion on UCG, a patient with a right atrial rupture can survive with a high probability, without the use of cardiopulmonary bypass.