[Injuries of the heart and para-cardiac large vessels].

Myocardial contusion is the most common manifestation of cardiac trauma; the true heart rupture or posttraumatic aneurysms are rare. Pericardial rupture can lead to cardiac strangulation; haemorrhagic pericardial effusion following trauma requires surgical drainage. Constrictive pericarditis occurs rarely after pericardial injury. Valve injury causes always the incompetence: traumatic aortic and mitral incompetence occur with both blunt and penetrating injury. In penetrating heart trauma a surgical revision is almost always necessary, to perform hemostasis and to decompress pericardial tamponade. Traumatic rupture of the descending thoracic aorta is amenable to immediate surgical treatment; end-to-end-anastomosis with simple aortic cross-clamping is the method of choice. Pump oxygenator is rarely necessary in treatment of cardiac trauma; emergency surgery--pericardial decompression, hemostasis and bilateral chest drainage--is performed in primary trauma center.