Traumatic Cardiac Rupture at the Superior Vena Cava-Right Atrial Junction in Four Pediatric Patients: A Case Series in China National Children’s Medical Center

TL;DR

Four children with heart injuries at a specific location were successfully treated with surgery after blunt trauma.

Contribution

Identifies the superior vena cava-right atrial junction as a unique vulnerable site in pediatric cardiac trauma.

Findings

All four pediatric patients had traumatic cardiac rupture at the SVC-RA junction confirmed by echocardiography.

Surgical repair without cardiopulmonary bypass led to full recovery in all patients.

Postoperative improvements in shock index and mean arterial pressure were statistically significant.

Abstract

This case series reports 4 paediatric patients (aged 2-11 years old) who sustained traumatic cardiac rupture following blunt trauma, all of whom were successfully treated at our institution. In contrast to common adult presentations, each case featured a rupture localized specifically to the superior vena cava-right atrial (SVC-RA) junction. Diagnosis was confirmed by echocardiography in the presence of cardiac tamponade. All patients underwent urgent median sternotomy, during which primary repair was accomplished without cardiopulmonary bypass. Postoperatively, both shock index and mean arterial pressure showed significant improvement (P = .003 and P = .028, respectively), and all children recovered fully without complications. This series highlights the SVC-RA junction as a uniquely vulnerable site in paediatric blunt cardiac injury and demonstrates that rapid diagnosis coupled with timely surgical intervention is paramount for survival.

Cardiac injury is associated with a high fatal condition.