Francisco (centre) with the team that saved him. / sur

Surgeons perform unique operation to save the life of accident victim with a five-centimetre hole in his heart

Specialists at the Regional Hospital in Malaga believe Francisco's case was unique, and say if there have been any others they have never been published in medical journals

Ángel Escalera

Surgeons at the Regional Hospital in Malaga have saved the life of a 75-year-old patient who suffered a serious cardiac rupture in a traffic accident. Sources at the hospital say they believe this has been a unique case, and if there have been others they have not been published in scientific journals.

The patient, Francisco Camacho Pascual, was taken to the hospital in a critical condition after the crash and doctors discovered a huge five-centimetre hole in the right wall of the heart. He was transferred to the acute cardiac intensive care unit, and the doctors believed he was unlikely to survive or, if he did, would be left with serious health problems.

A life or death operation

Further examination showed that the cardiac rupture was not contained and his life was in imminent danger, so he was taken for immediate surgery. The situation was especially critical because he had previously had an operation to remove the pericardium, the membrane that surrounds the heart to protect it, so there was a high risk of complications arising during the surgery.

The surgical team connected Francisco to an extracorporeal surgical pump, and were able to empty the heart of blood before opening the sternum, thereby preventing him dying from blood loss.

“After detaching adhesions from previous surgery, we located the cardiac defect and were able to repair it by suturing a patch of bovine pericardium to the walls of the ventricle", explained surgeon José Francisco Valderrama afterwards.

This was done while the heart was beating and on an extremely fragile ventricular wall. Once the surgery was completed, Francisco was taken back to intensive care to recover, and remained there for 40 days until he was able to breathe unaided, and he was then moved to a ward. He has just been discharged from the hospital and returned home.

A rupture in one of the cavities of the heart can occur for several reasons. Sometimes it can be caused by illnesses such as myocardial infarction or acute myocarditis, or as the result of a complication of cardiac surgery or injuries caused by a knife or firearm. It can also be the result of blunt trauma to the sternum, such as cardiac massage in cardiopulmonary resuscitation, a fall from a great height or, as in Francisco’s case, a traffic accident, which is the most common.